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General NPI Number Information
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NPI Number | 1578071874
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Entity Type | Individual
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Provider Name | JENNIFER MILLARD PA
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Gender | Female
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Dates
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Enumeration Date | 01/21/2018
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 800 ROSE ST FL 1
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City | LEXINGTON
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State | KY
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Zip | 40536-7001
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Country | US
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Telephone | 859-562-1085
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Fax | 859-257-5152
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Provider Business Mailing Address
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Address Line | 4019 BALLARD WOODS DR
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City | SMITHFIELD
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State | KY
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Zip | 40068-9324
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Country | US
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Telephone | 720-346-3070
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | TC073
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 86044806
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | TC073
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | KY
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