| Doctor Name: | JANA RENEE GANTLEY |
| NPI Number: | 1033159827 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | 3002241 |
| Business Practice Address: | 555 W Sun St Morehead, KY - 403511563 |
| Business Phone Number: | 6062072931 |
| Business Fax Number: | 6067830964 |
| Mailing Address: | 555 W Sun St, MOREHEAD |
| State: | KY |
| Postal Code: | 403511563 |
| Phone Number: | 6062072931 |
| Fax Number: | 6067830964 |
| NPI Enumeration Date: | 06/08/2006 |
| NPI Last Update Date: | 08/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | 3002241 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |