Basic Information
| Provider Information | |||||||||
| NPI: | 1144418310 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JINNY R. VICROY, ARNP PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2040 REGENCY RD | ||||||||
| Address2: | SUITE F | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405032331 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592761946 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2040 REGENCY RD | ||||||||
| Address2: | SUITE F | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405032331 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592761946 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2007 | ||||||||
| LastUpdateDate: | 10/12/2007 | ||||||||
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| AuthorizedOfficialLastName: | VICROY | ||||||||
| AuthorizedOfficialFirstName: | JINNY | ||||||||
| AuthorizedOfficialMiddleName: | RAE | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8592761946 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | ARNP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 1041085 | KY | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.