Healthcare Provider Details

I. General information

NPI: 1376142349
Provider Name (Legal Business Name): JENNIFER TURNER WHITAKER PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2020
Last Update Date: 09/16/2026
Certification Date: 10/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2034 S HIGHWAY 53
LA GRANGE KY
40031-9535
US

IV. Provider business mailing address

3706 BALLARD WOODS CT
SMITHFIELD KY
40068-9329
US

V. Phone/Fax

Practice location:
  • Phone: 502-222-2028
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number011398
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: