Provider Demographics
NPI:1962481408
Name:LEMMONS, JO ANN (APRN)
Entity Type:Individual
Prefix:
First Name:JO
Middle Name:ANN
Last Name:LEMMONS
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 309
Mailing Address - Street 2:GREEN RIVER DISTRICT HEALTH DEPARTMENT
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42302-0309
Mailing Address - Country:US
Mailing Address - Phone:270-686-7744
Mailing Address - Fax:270-926-9862
Practice Address - Street 1:1600 BRECKENRIDGE ST
Practice Address - Street 2:DAVIS COUNTY HEALTH CENTER
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-1055
Practice Address - Country:US
Practice Address - Phone:270-686-7744
Practice Address - Fax:270-926-8677
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3002103363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100040280Medicaid
KY0049215Medicare PIN
P62587Medicare UPIN
KY0282413Medicare PIN