Provider Demographics
NPI:1982342879
Name:JANKOSKI, NINA (APRN, AGACNP)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:JANKOSKI
Suffix:
Gender:F
Credentials:APRN, AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 STONE HOUSE TRL
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-9454
Mailing Address - Country:US
Mailing Address - Phone:502-974-0081
Mailing Address - Fax:
Practice Address - Street 1:117 STONE HOUSE TRL
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-9454
Practice Address - Country:US
Practice Address - Phone:502-974-0081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-22
Last Update Date:2022-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017669363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology