Healthcare Provider Details

I. General information

NPI: 1679501308
Provider Name (Legal Business Name): JENNA LYNN BUCHANAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNA LYNN MURRAY

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 08/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 REGENCY RD. STE. 101 ACCESS WELLNESS GROUP
LEXINGTON KY
40503
US

IV. Provider business mailing address

510 SPRING ST
JEFFERSONVILLE IN
47130-3554
US

V. Phone/Fax

Practice location:
  • Phone: 859-309-0309
  • Fax: 859-309-0914
Mailing address:
  • Phone: 812-282-1888
  • Fax: 812-218-9318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3007808
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3007808
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: