Provider Demographics
NPI:1134090095
Name:PHARIS, JAYME LAUREN
Entity type:Individual
Prefix:
First Name:JAYME
Middle Name:LAUREN
Last Name:PHARIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1072 LILAC RD
Mailing Address - Street 2:
Mailing Address - City:LEITCHFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42754-8601
Mailing Address - Country:US
Mailing Address - Phone:270-868-0537
Mailing Address - Fax:
Practice Address - Street 1:2022 BATTERY PARK DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:KY
Practice Address - Zip Code:42740-8800
Practice Address - Country:US
Practice Address - Phone:270-868-0537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1165569163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health