Most Relevant Information
Provider Data
| NPI Number: | 1003434317 |
| Provider Name: | ELIZABETH JEAN LOAN APRN |
| Entity Type: | Individual |
| Taxonomy Code: | 163WG0000X |
| Specialty: | Registered Nurse |
| License Number: | 198028 |
Most Important Dates
| Enumeration Date: | 07/13/2020 |
| Last Updated: | 12/14/2020 |
Provider Practice Location
2201 LEXINGTON AVE
ASHLAND
KY
411012843
Practice Location Phone/Fax
| Phone: | 6064084000 |
| Fax: |
Provider Mailing Location
PO BOX 1595
ASHLAND
KY
411051595
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |