Healthcare Provider Details
I. General information
NPI: 1851511158
Provider Name (Legal Business Name): JENNIFER MARIE ERNST-PIERSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/27/2007
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
334 THOMAS MORE PKWY
CRESTVIEW HILLS KY
41017-3464
US
IV. Provider business mailing address
PO BOX 635283
CINCINNATI OH
45263-5283
US
V. Phone/Fax
- Phone: 859-578-3400
- Fax: 859-957-0055
- Phone: 859-578-3400
- Fax: 859-957-0055
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 35088121 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 41884 |
| License Number State | KY |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 41884 |
| License Number State | KY |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 35088121 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: