Provider Demographics
NPI:1215313036
Name:BIRCHALL, JASMINE (APRN)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:BIRCHALL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 845
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:KY
Mailing Address - Zip Code:41095-0845
Mailing Address - Country:US
Mailing Address - Phone:859-567-1591
Mailing Address - Fax:859-567-1253
Practice Address - Street 1:441 US HIGHWAY 42 W
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:KY
Practice Address - Zip Code:41095-7513
Practice Address - Country:US
Practice Address - Phone:859-567-1591
Practice Address - Fax:859-567-1271
Is Sole Proprietor?:No
Enumeration Date:2015-08-04
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3009565363L00000X, 363LF0000X, 363LP0808X
IN71012714A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily