Provider Demographics
NPI:1467853879
Name:VANCE, JAMIE SHEREE (ARNP)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:SHEREE
Last Name:VANCE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:SHEREE
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:784 HIGHWAY 36
Mailing Address - Street 2:
Mailing Address - City:FRENCHBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40322-8123
Mailing Address - Country:US
Mailing Address - Phone:606-768-9190
Mailing Address - Fax:
Practice Address - Street 1:784 HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:FRENCHBURG
Practice Address - State:KY
Practice Address - Zip Code:40322-8123
Practice Address - Country:US
Practice Address - Phone:606-768-9190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1099455363LF0000X
KY3008933363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100315320Medicaid
KYMC4386149OtherKY DEA
KYK158711Medicare PIN
KYK158712Medicare PIN
KYK158713Medicare PIN