Prahl, Jessica Brooke

Prahl, Jessica Brooke is an individual health care provider with primary practice located at 1111 Ring Rd Suite 100, Elizabethtown KY 42701-4900. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Prahl, Jessica Brooke can be contacted via phone (270) 706-5515.

Contact Information

Primary practice address
1111 Ring Rd Suite 100 Elizabethtown KY 42701-4900
Phone: (270) 706-5515
Fax: (270) 706-5516
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1336492677
LBN Legal business name Prahl, Jessica Brooke
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2012
Last updated Sep 19th, 2016 - about 9 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 1336492677 NPPES
Kentucky MEDICAID 7100255980

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