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1346624962
JASMAINE THEOBALD
PADUCAH, KY
NPI
1346624962
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: KY 3009523)
Enumeration Date
2015-07-14
Last Update Date
2019-12-03
Business Address
JASMAINE THEOBALD APRN
2601 KENTUCKY AVE SUITE 103
PADUCAH, KY 42003-3817
Phone number: 270-415-4860
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Mailing Address
JASMAINE THEOBALD APRN
2700 STANLEY GAULT PKWY STE 129
LOUISVILLE, KY 40223-5176
Phone number: 502-253-4900
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