Provider Demographics
NPI:1730180548
Name:JONAH, NIKOLINA O (MD)
Entity type:Individual
Prefix:
First Name:NIKOLINA
Middle Name:O
Last Name:JONAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 MEDICAL HEIGHTS DR
Mailing Address - Street 2:STE D
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-4137
Mailing Address - Country:US
Mailing Address - Phone:502-875-2468
Mailing Address - Fax:502-875-2485
Practice Address - Street 1:101 MEDICAL HEIGHTS DR
Practice Address - Street 2:STE D
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-4137
Practice Address - Country:US
Practice Address - Phone:502-875-2468
Practice Address - Fax:502-875-2485
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY35654207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000000108140OtherBLUE ACCESS BLUE PREFERRE
KY64011976Medicaid
KY64011976Medicaid
H15157Medicare UPIN