Provider Demographics
NPI:1093254930
Name:MCMAINE, JESSICA THOMAS (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:THOMAS
Last Name:MCMAINE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40743-0936
Mailing Address - Country:US
Mailing Address - Phone:859-744-5111
Mailing Address - Fax:606-330-7825
Practice Address - Street 1:1850 BYPASS RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-2300
Practice Address - Country:US
Practice Address - Phone:859-744-5111
Practice Address - Fax:859-744-1177
Is Sole Proprietor?:No
Enumeration Date:2017-02-13
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1121728163WD0400X
KY3017929363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator