Individual
JENNIFER DEE DEACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1 AUDUBON PLAZA DR, LOUISVILLE, KY 40217-1318
(502) 634-6767
(502) 634-6775
Mailing address
PO BOX 36218, LOUISVILLE, KY 40233-6218
(502) 634-6767
(502) 634-6775
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3013621
KY
Other
Enumeration date
07/29/2019
Last updated
07/29/2019
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