MEDICARE: JENNA BRATCHER APRN

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	363L00000X	Nurse Practitioner	3006163	KY
2	363LF0000X	Family Nurse Practitioner	3006163	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639402316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA BRATCHER APRN

Provider Business Mailing Address
First Line	:	722 W MAIN ST
Second Line	:
City	:	CLARKSON
State	:	KY
Zip	:	42726-7048
Country	:	US
Telephone Number	:	270-971-1231
Fax Number	:	270-971-1411

Provider Business Practice Location Address
First Line	:	722 W MAIN ST
Second Line	:
City	:	CLARKSON
State	:	KY
Zip	:	42726-7048
Country	:	US
Telephone Number	:	270-971-1231
Fax Number	:	270-971-1411

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

Provider Enumeration Date	:	09/11/2009
Last Update Date	:	03/04/2025

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