Dismore Wrinkles, Jenna Leigh

Dismore Wrinkles, Jenna Leigh is an individual health care provider with primary practice located at 1107 Crown Pointe Dr Ste 107 , Elizabethtown KY 42701-7280. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as her primary health care specialty. Dismore Wrinkles, Jenna Leigh can be contacted via phone (270) 506-3300.

Contact Information

Primary practice address
1107 Crown Pointe Dr Ste 107 Elizabethtown KY 42701-7280
Fax: (270) 506-2843
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 01075865A Indiana
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 47108 Kentucky

Profile Details

NPI number 1780909952
LBN Legal business name Dismore Wrinkles, Jenna Leigh
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2010
Last updated Jun 9th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780909952 NPPES
Indiana Other P01957674 RAILROAD MEDICARE
Indiana Other 1232438 RAILROAD MEDICARE
Indiana MEDICAID 201317930 RAILROAD MEDICARE
Indiana Other P01590218 RAILROAD MEDICARE
Indiana Other 5661958 RAILROAD MEDICARE
Indiana Other CS1612000141 RAILROAD MEDICARE
Indiana Other 005625439 RAILROAD MEDICARE
Indiana Other 000000963791 RAILROAD MEDICARE
Indiana Other 339847KYIP RAILROAD MEDICARE
Indiana Other 2355628 RAILROAD MEDICARE
Indiana MEDICAID 7100167720 RAILROAD MEDICARE

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