| Doctor Name: | JERRI L HARLEN |
| NPI Number: | 1295119915 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | 3009543 |
| Business Practice Address: | 130 S Joe B Hall Ave Shepherdsville, KY - 401656009 |
| Business Phone Number: | 5025898600 |
| Business Fax Number: | 5022670662 |
| Mailing Address: | 101 W Muhammad Ali Blvd, LOUISVILLE |
| State: | KY |
| Postal Code: | 402021423 |
| Phone Number: | 5025898600 |
| Fax Number: | 5022870662 |
| NPI Enumeration Date: | 07/13/2015 |
| NPI Last Update Date: | 08/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 3009543 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |