Jeanne Herald, PMHNP-BC

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Wilmore, KY

NPI 1114357563 · NPPES record last updated Aug 23, 2023

Key facts

NPI
1114357563
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
3008247 (KY)
Practice address
100 Veterans Dr
Wilmore, KY 40390-9775
Phone
(859) 858-2814
NPI assigned
Nov 22, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3008247 KY Yes

Addresses

Primary practice location

100 Veterans Dr
Wilmore, KY 40390-9775

Mailing address

100 Veterans Dr
Wilmore, KY 40390-9775
Phone (859) 858-2814

Other names

  • Jeanne Marie Lark Other name

Other providers in Wilmore, KY

All providers in Wilmore, KY · Psychiatric/Mental Health Nurse Practitioner in Kentucky

Sources for this page

Verify at the official NPI Registry.