Provider Demographics
NPI:1245901495
Name:THE NPFACTORY AND JANEL WILLINGHAM LLC
Entity type:Organization
Organization Name:THE NPFACTORY AND JANEL WILLINGHAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ NURSE PRACITITONER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANEL
Authorized Official - Middle Name:JENE
Authorized Official - Last Name:WILLINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:502-802-0692
Mailing Address - Street 1:3103 BRECKENRIDGE LN STE 2
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-2798
Mailing Address - Country:US
Mailing Address - Phone:502-384-7053
Mailing Address - Fax:
Practice Address - Street 1:3103 BRECKENRIDGE LN STE 2
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-2798
Practice Address - Country:US
Practice Address - Phone:502-384-7053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care