MEDICARE: MRS. TRACY JENNINGS RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	011001	KY

General Provider Information

NPI Number	:	1407216153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TRACY JENNINGS RPH

Provider Business Mailing Address
First Line	:	10 BARRINGTON RD
Second Line	:
City	:	FT WRIGHT
State	:	KY
Zip	:	41011-2604
Country	:	US
Telephone Number	:	859-331-1272
Fax Number	:

Provider Business Practice Location Address
First Line	:	2150 DIXIE HWY
Second Line	:
City	:	FORT MITCHELL
State	:	KY
Zip	:	41017-2902
Country	:	US
Telephone Number	:	859-331-0078
Fax Number	:	859-331-3478

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2016
Last Update Date	:	05/29/2026

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