Individual
JESSICA DSOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
9200 SHELBYVILLE RD # 530, LOUISVILLE, KY 40222-5144
(502) 327-9100
(855) 632-8329
Mailing address
9200 SHELBYVILLE RD # 530, LOUISVILLE, KY 40222-5144
(502) 327-9100
(855) 632-8329
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
3005679
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000593459
BCBS
KY
01
—
P00706703
RAILROAD MEDICARE
KY
Enumeration date
08/18/2008
Last updated
07/21/2022
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