Provider Demographics
NPI:1699766543
Name:HARLEY, JANE RAMEY (APRN)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:RAMEY
Last Name:HARLEY
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 1:5123 WITHORN SQ
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-5200
Mailing Address - Country:US
Mailing Address - Phone:502-426-9170
Mailing Address - Fax:
Practice Address - Street 1:920 DUPONT RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4692
Practice Address - Country:US
Practice Address - Phone:502-895-2334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1869P363LF0000X
KY3001869363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily