Provider Demographics
NPI:1255692232
Name:BISEL, JAMIE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:
Last Name:BISEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2851 NEW HARTFORD RD
Mailing Address - Street 2:STE A
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-1320
Mailing Address - Country:US
Mailing Address - Phone:270-240-2305
Mailing Address - Fax:270-240-2252
Practice Address - Street 1:2200 E PARRISH AVE
Practice Address - Street 2:SUITE 201B
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-1449
Practice Address - Country:US
Practice Address - Phone:270-926-3700
Practice Address - Fax:270-926-2114
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2017-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA1845363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical