Individual
JENNIFER CARRIE WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
2501 KENTUCKY AVE, PADUCAH, KY 42003
(270) 575-8472
(270) 441-4707
Mailing address
2501 KENTUCKY AVE, PADUCAH, KY 42003
(270) 575-8472
(270) 441-4707
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3004998
KY
363LA2100X
Acute Care Nurse Practitioner
Primary
3004998
KY
363LA2100X
Acute Care Nurse Practitioner
4988P
KY
Other
Enumeration date
10/10/2006
Last updated
07/19/2019
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