Jessica Danielle Blust, LPN

Individual provider Active NPI Licensed Practical Nurse · Villa Hills, KY

NPI 1265866701 · NPPES record last updated Mar 31, 2016

Key facts

NPI
1265866701
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN.138705-M-IV (OH)
Practice address
907 Kenridge Dr
Villa Hills, KY 41017
Phone
(513) 237-8283
NPI assigned
Aug 31, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2046175KYMDLicensed Practical Nurse
PN.138705-M-IVOHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN.138705-M-IV OH Yes
Licensed Practical Nurse 164W00000X 2046175 KY

Addresses

Primary practice location

907 Kenridge Dr
Villa Hills, KY 41017

Mailing address

907 Kenridge St
Villa Hills, KY 41017-1155
Phone (513) 237-8283

Other providers in Villa Hills, KY

All providers in Villa Hills, KY · Licensed Practical Nurse in Kentucky

Sources for this page

Verify at the official NPI Registry.