Provider Demographics
NPI:1932598117
Name:GISH, JAIME (APRN)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:GISH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2915 NEW HARTFORD RD
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-1323
Mailing Address - Country:US
Mailing Address - Phone:270-852-1645
Mailing Address - Fax:270-852-1646
Practice Address - Street 1:2915 NEW HARTFORD RD
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-1323
Practice Address - Country:US
Practice Address - Phone:270-852-1645
Practice Address - Fax:270-852-1646
Is Sole Proprietor?:No
Enumeration Date:2015-01-12
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008981363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3008981OtherAPRN