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NPI 1578992590

NPI 1578992590 : JENNIFER FOWEE : HIGHLAND HEIGHTS, KY

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General NPI Number Information
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    NPI Number           |    1578992590
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    Entity Type          |    Individual 
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    Provider Name        |    JENNIFER FOWEE
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/12/2013
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    Last Update Date     |    10/01/2015
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Provider Practice Location Address
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    Address Line         |    2885 ALEXANDRIA PIKE 
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    City                 |    HIGHLAND HEIGHTS
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    State                |    KY
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    Zip                  |    41076-1511
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    Country              |    US
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    Telephone            |    859-757-0434
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    Fax                  |    859-441-0906
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Provider Business Mailing Address
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    Address Line         |    2300 CHAMBER CENTER DR SUITE 200
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    City                 |    LAKESIDE PARK
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    State                |    KY
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    Zip                  |    41017-1673
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    Country              |    US
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    Telephone            |    859-757-0434
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    Fax                  |    859-441-0906
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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        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    3008388
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    License Number State |    KY
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