| Mrs Jessica Ryan Hall, CNP | |
|
2300 Chamber Center Dr, Lakeside Park, KY 41017 | |
| (859) 655-7040 | |
| (859) 331-2021 |
| Full Name | Mrs Jessica Ryan Hall |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 13 Years |
| Location | 2300 Chamber Center Dr, Lakeside Park, Kentucky |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194165399 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LA2200X | Nurse Practitioner - Adult Health | COA.14129-NP (Ohio) | Secondary |
| 363L00000X | Nurse Practitioner | 3013821 (Kentucky) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Elizabeth Edgewood | Edgewood, KY | Hospital |
| St Elizabeth Florence | Florence, KY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Summit Medical Group Inc | 2163326240 | 756 |
| Entity Name | Summit Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508287640 PECOS PAC ID: 2163326240 Enrollment ID: O20031120000738 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Jessica Ryan Hall, CNP Po Box 635283, Cincinnati, OH 45263-5283 Ph: () - | Mrs Jessica Ryan Hall, CNP 2300 Chamber Center Dr, Lakeside Park, KY 41017 Ph: (859) 655-7040 |
Laurie A. Wallace, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2156 Chamber Center Dr, Lakeside Park, KY 41017 Phone: 859-341-6255 Fax: 859-547-1197 | |
Jessica R Vaniglia, CNM Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2156 Chamber Center Dr, Lakeside Park, KY 41017 Phone: 859-282-6700 Fax: 859-282-6760 | |
Jacqueline Leight Reichert Grimes, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 334 Farmington Dr, Lakeside Park, KY 41017 Phone: 859-446-6263 |