Most Relevant Information
Provider Data
| NPI Number: | 1003291360 |
| Provider Name: | JEANIE NICOLE DOOM APRN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 3009544 |
Most Important Dates
| Enumeration Date: | 07/28/2015 |
| Last Updated: | 08/26/2024 |
Provider Practice Location
627 W FAIRVIEW AVE
EDDYVILLE
KY
420387386
Practice Location Phone/Fax
| Phone: | 2703885454 |
| Fax: | 2703885452 |
Provider Mailing Location
1901 CAMPUS PL
LOUISVILLE
KY
402992308
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |