Provider Demographics
NPI:1912413824
Name:GREENE, JAYLA (APRN)
Entity Type:Individual
Prefix:
First Name:JAYLA
Middle Name:
Last Name:GREENE
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:2700 STANLEY GAULT PKWY STE 129
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5176
Mailing Address - Country:US
Mailing Address - Phone:502-253-4910
Mailing Address - Fax:502-489-5751
Practice Address - Street 1:3900 KRESGE WAY STE 56
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4683
Practice Address - Country:US
Practice Address - Phone:502-895-7265
Practice Address - Fax:502-897-2032
Is Sole Proprietor?:No
Enumeration Date:2017-12-15
Last Update Date:2020-12-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY3011506363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care