JESSICA LAUREN MAMULA (NPI# 1679043319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679043319 |
| Entity Type | Individual |
| Full Name | JESSICA LAUREN MAMULA |
| Credential | PMHNP-BC |
| Practice Address |
3991 Dutchmans Ln Ste 405 Louisville KY 40207-4723 |
| Mailing Address |
Po Box 776347 Chicago IL 60677-6347 |
| Practice Telephone | 5028993366 |
| Mailing Telephone | 5022725052 |
| Mailing Fax Number | 5026296217 |
| Enumeration Date | 2018-11-26 |
| Last Update Date | 2018-12-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
3012906 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3991 DUTCHMANS LN STE 405 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40207-4723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851540017 | Katharine E Adelstein | Nurse Practitioner | 3991 Dutchmans Ln Ste 405, Louisville, KY 40207-4723 | 2008-09-12 |
| 1962964684 | Chelsea Ann Menke | Student in an Organized Health Care Education/Training Program | 3991 Dutchmans Ln Ste 405, Louisville, KY 40207-4723 | 2019-04-02 |
| 1528582285 | Christin Paige Thompson | Nurse Practitioner | 3991 Dutchmans Ln Ste 405, Louisville, KY 40207-4723 | 2017-08-03 |
| 1043502206 | Joseph James Maly | Internal Medicine | 3991 Dutchmans Ln Ste 405, Louisville, KY 40207-4723 | 2011-05-06 |
| 1588984884 | Brittany M. Ross | Nurse Practitioner | 3991 Dutchmans Ln Ste 405, Louisville, KY 40207-4723 | 2010-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780212688 | Alexia Louise Bodamer | Student in an Organized Health Care Education/Training Program | 142 Chenoweth Lane, Lousiville, KY 40207 | 2020-03-28 |
| 1467918664 | Amy Rock LLC | Counselor | 4010 Dupont Cir Ste 307, Louisville, KY 40207 | 2019-02-13 |
| 1649745191 | Louisville Optometric Center, IIi, Psc | Optometrist | 285 Hubbards Lane, Suite 300, Louisville, KY 40207 | 2018-10-11 |
| 1184137440 | Crimson Dove Counseling Services Inc | Community/Behavioral Health | 214 Breckenridge Ln., Suite 203, Louisville, KY 40207 | 2017-11-09 |
| 1285157586 | Dickerson Family Enterprise, LLC | Non-emergency Medical Transport (VAN) | 4350 Brownsboro Rd., Ste. 110, Louisville, KY 40207 | 2017-07-19 |
| 1578085296 | Cardiovascular Medical Specialists LLC | Surgery | 100 Mallard Creek Rd Ste 150, Louisville, KY 40207 | 2017-07-14 |
| 1932636305 | Devon Turley | Prevention Professional | 1017 Dupont Rd, Suite 1, Louisville, KY 40207 | 2017-05-17 |
| 1285095539 | Emily Schwartz Crouch | Marriage & Family Therapist | 4010 Dupont Circle, Suite 582, Louisville, KY 40207 | 2016-03-15 |
| 1306201280 | A A and Associates Approved Alcohol/drug Program | Counselor | 4006 Dutchmans Lane, Louisville, KY 40207 | 2015-12-21 |
| 1629433693 | Jewish Hospital and St. Mary's Healthcare, Inc. | General Acute Care Hospital | 3290 Dutchmans Lane, Louisville, KY 40207 | 2015-12-17 |
| Find all providers in zip 40207 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811594385 | Christine Young | Nurse Practitioner | 6804 Bainbridge Ct, Louisville, KY 40228-2335 | 2020-10-07 |
| 1255948154 | Kathleen B Berghausen | Nurse Practitioner | 4112 Fern Valley Rod, Louisville, KY 40219 | 2020-09-25 |
| 1285243477 | Stephanie Atherton | Nurse Practitioner | 1623 Story Ave, Louisville, KY 40206 | 2020-07-24 |
| 1235768037 | Patricia Amber Estes | Nurse Practitioner | 234 E Gray St Ste 154, Louisville, KY 40202-1903 | 2020-04-03 |
| 1659903201 | Farrah Alayne Thornsberry | Nurse Practitioner | 1400 Browns Ln Ste B, Louisville, KY 40207-4696 | 2020-02-11 |
| 1376101634 | Erin Lee Srader | Nurse Practitioner | 544 Baxter Ave, Louisville, KY 40204-1784 | 2019-06-03 |
| 1104387752 | Kurt F Kristiansen | Nurse Practitioner | 1862 Douglass Blvd, Louisville, KY 40205-1851 | 2019-03-27 |
| 1831573351 | Karen P Black | Nurse Practitioner | 4504 Spring Bay Ct, Louisville, KY 40241-1773 | 2015-07-14 |
| 1366787798 | Kennetha Porter | Nurse Practitioner | 4710 Champions Trace Ln Ste 102, Louisville, KY 40218-3496 | 2012-12-12 |
| 1407104128 | Tammy Rowland Reddington | Nurse Practitioner | 4004 Hurstbroune Woods Drive, Louisville, KY 40299 | 2012-08-28 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40207 |
Please comment or provide details below to improve the information on JESSICA LAUREN MAMULA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.