Healthcare Provider Details

I. General information

NPI: 1619800265
Provider Name (Legal Business Name): JENNIFER ROSE SLAUBAUGH APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5294 BAKERS SPRING ST APT 113
BOWLING GREEN KY
42101-7732
US

IV. Provider business mailing address

5294 BAKERS SPRING ST APT 113
BOWLING GREEN KY
42101-7732
US

V. Phone/Fax

Practice location:
  • Phone: 270-999-2547
  • Fax: 270-999-2547
Mailing address:
  • Phone: 270-999-2547
  • Fax: 270-999-2547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1136840
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: