Provider Demographics
NPI:1871299149
Name:HEBBLETHWAITE, JANICE ELAINE (APRN)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:ELAINE
Last Name:HEBBLETHWAITE
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 1:700 ELM RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-5419
Mailing Address - Country:US
Mailing Address - Phone:770-548-9099
Mailing Address - Fax:
Practice Address - Street 1:75 NATURE TRL
Practice Address - Street 2:
Practice Address - City:RADCLIFF
Practice Address - State:KY
Practice Address - Zip Code:40160-9111
Practice Address - Country:US
Practice Address - Phone:270-351-2323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11024347363LF0000X
KY4024489363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily