Granese, Jacqueline
Granese, Jacqueline is an individual health care provider with primary practice located at 1065 Ashley St Ste 200 , Bowling Green KY 42103-3401. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatopathology, which is considered as her primary health care specialty. Granese, Jacqueline can be contacted via phone (270) 843-3376.Contact Information
Primary practice address
1065 Ashley St Ste 200
Bowling Green KY 42103-3401
Phone: (270) 843-3376
Fax: (270) 780-0496
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ND0900X | 42560 | Kentucky |
Profile Details
| NPI number | 1649479460 |
|---|---|
| LBN Legal business name | Granese, Jacqueline |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2007 |
| Last updated | Jul 21st, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649479460 | NPPES |
| Kentucky | MEDICAID | 7100072860 |
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