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General NPI Number Information
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NPI Number | 1508474743
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Entity Type | Individual
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Provider Name | JENNIFER BIVINS DNP, APRN
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Gender | Female
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Dates
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Enumeration Date | 07/14/2020
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Last Update Date | 07/14/2020
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Provider Practice Location Address
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Address Line | 138 LEADER AVE
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City | LEXINGTON
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State | KY
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Zip | 40508-3215
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Country | US
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Telephone | 419-461-6502
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Fax |
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Provider Business Mailing Address
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Address Line | 128 EDGEMOOR DR
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City | LEXINGTON
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State | KY
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Zip | 40503-2007
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Country | US
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Telephone | 419-461-6502
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 3014086
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License Number State | KY
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