Provider Demographics
NPI:1013756121
Name:SCHMALLE, JESSICA LOUISE (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LOUISE
Last Name:SCHMALLE
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 ROBERT TAYLOR LN
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:KY
Mailing Address - Zip Code:40051-6024
Mailing Address - Country:US
Mailing Address - Phone:502-331-1314
Mailing Address - Fax:
Practice Address - Street 1:1360 ROGERSVILLE RD
Practice Address - Street 2:
Practice Address - City:RADCLIFF
Practice Address - State:KY
Practice Address - Zip Code:40160-9344
Practice Address - Country:US
Practice Address - Phone:270-351-1150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4021126363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily