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General NPI Number Information
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NPI Number | 1881102739
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Entity Type | Individual
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Provider Name | JENNIFER HAWKINS PENTECOST APRN, FNP-C, CLC
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Gender | Female
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Dates
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Enumeration Date | 01/12/2018
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 4001 DUTCHMANS LN
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City | LOUISVILLE
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State | KY
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Zip | 40207-4714
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Country | US
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Telephone | 502-893-1270
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Fax | 502-894-1321
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Provider Business Mailing Address
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Address Line | PO BOX 776351
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City | CHICAGO
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State | IL
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Zip | 60677-6351
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Country | US
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Telephone | 502-559-9425
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Fax | 502-272-5339
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1112785
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 4048665
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3012362
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 4048665
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3012362
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License Number State | KY
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4048665
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License Number State | KY
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