Provider Demographics
NPI:1649507898
Name:FLASHMAN, JESSICA LAUREN (MED)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:LAUREN
Last Name:FLASHMAN
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3220 BLENHEIM WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3474
Mailing Address - Country:US
Mailing Address - Phone:347-385-9470
Mailing Address - Fax:
Practice Address - Street 1:3220 BLENHEIM WAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3474
Practice Address - Country:US
Practice Address - Phone:347-385-9470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY201123287252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency