Wilson, Jennifer L

Wilson, Jennifer L is an individual health care provider with primary practice located at 3050 Harrodsburg Rd Ste 100, Lexington KY 40503-2747. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Adolescent Medicine. Allopathic & Osteopathic Physicians / Adolescent Medicine is her primary health care specialty. Wilson, Jennifer L can be contacted via phone (859) 277-6102.

Contact Information

Primary practice address
3050 Harrodsburg Rd Ste 100 Lexington KY 40503-2747
Phone: (859) 277-6102
Fax: (859) 977-0237
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 41107 Kentucky
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 052858 Georgia
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 41107 Kentucky

Profile Details

NPI number 1043321748
LBN Legal business name Wilson, Jennifer L
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Jan 5th, 2024 - about 11 months 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 1043321748 NPPES
Kentucky MEDICAID 7100028860
Kentucky MEDICAID G52858
Kentucky MEDICAID 135542874A

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