Provider Demographics
NPI:1053045716
Name:HULL, JENNA (LPN)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:HULL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4512 W PLEASANT HILL RD
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-9275
Mailing Address - Country:US
Mailing Address - Phone:785-914-7176
Mailing Address - Fax:
Practice Address - Street 1:4512 W PLEASANT HILL RD
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-9275
Practice Address - Country:US
Practice Address - Phone:785-914-7176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-10
Last Update Date:2022-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS23-51731-102164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse