Mattingly, Jennifer

Mattingly, Jennifer is an individual health care provider with primary practice located at 245 Flemingsburg Rd , Morehead KY 40351-1015. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Mattingly, Jennifer can be contacted via phone (606) 780-5500.

Contact Information

Primary practice address
245 Flemingsburg Rd Morehead KY 40351-1015
Phone: (606) 780-5500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA1926 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA525 Kentucky

Profile Details

NPI number 1326326935
LBN Legal business name Mattingly, Jennifer
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 30th, 2011
Last updated Feb 10th, 2022 - about 3 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 1326326935 NPPES
Kentucky Other PA525 KY MEDICAL LICENSE
Kentucky MEDICAID 95002390 KY MEDICAL LICENSE

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