Individual
JESSICA HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1301 N RACE ST, GLASGOW, KY 42141-3483
(270) 651-4134
(270) 651-4234
Mailing address
639 N MULBERRY ST, ELIZABETHTOWN, KY 42701-1931
(270) 737-4600
(270) 737-1722
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1131834
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100646720
—
KY
Enumeration date
08/14/2019
Last updated
04/20/2021
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