JACKIE STETHEM NPI 1740848324

NPI Information

NPI: 1740848324
Provider Name: JACKIE STETHEM
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Organization: RIDGE OUTPATIENT COUNSELING, LLC

PECOS Registration: Yes

Address:
3050 RIO DOSA DR
LEXINGTON, KY
ZIP 40509
Phone: (859) 269-2325
Get Directions

Jackie Stethem is a psychiatric/mental health nurse practitioner in Lexington, KY with 5 years of experience. Jackie Stethem NPI is 1740848324. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3050 RIO DOSA DR
LEXINGTON, KY
ZIP 40509-540
Phone: (859) 269-2325

The NPI 1740848324 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/30/2019 and was last updated on 10/9/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	3013689	KENTUCKY	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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