Individual
ELAINE B. JIVIDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1000 ASHLAND DR STE 301, ASHLAND, KY 41101-7084
(606) 326-0322
(606) 326-9809
Mailing address
PO BOX 1447, ASHLAND, KY 41105-1447
(606) 326-0322
(606) 326-9809
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
6411S
KY
Other
Enumeration date
03/31/2010
Last updated
03/31/2010
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