Mattingly, Jeannie Maria

Mattingly, Jeannie Maria is an sole proprietor health care provider with primary practice located at 125 S Main Cross St , Louisa KY 41230-1065. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Mattingly, Jeannie Maria can be contacted via phone (606) 638-0938.

Contact Information

Primary practice address
125 S Main Cross St Louisa KY 41230-1065
Phone: (606) 638-0938
Fax: (859) 813-5394
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3007362 Kentucky

Profile Details

NPI number 1326314824
LBN Legal business name Mattingly, Jeannie Maria
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 28th, 2012
Last updated Dec 13th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326314824 NPPES
Kentucky MEDICAID 7100233430

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