Provider Demographics
NPI:1962829796
Name:NANCE, JAMIE A (APRN)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:A
Last Name:NANCE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:A
Other - Last Name:SIMPSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 23229
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42304-3229
Mailing Address - Country:US
Mailing Address - Phone:270-691-8070
Mailing Address - Fax:270-691-8026
Practice Address - Street 1:440 HOPKINSVILLE ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:KY
Practice Address - Zip Code:42345-1124
Practice Address - Country:US
Practice Address - Phone:270-338-8302
Practice Address - Fax:270-338-8427
Is Sole Proprietor?:No
Enumeration Date:2014-03-18
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008549363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100290860Medicaid
KYK126422Medicare PIN
KY7100290860Medicaid