Provider Demographics
NPI:1184852659
Name:WEST, JENNIFER J (ARNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:J
Last Name:WEST
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1080
Mailing Address - Street 2:
Mailing Address - City:BURKESVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42717-1080
Mailing Address - Country:US
Mailing Address - Phone:270-864-1472
Mailing Address - Fax:270-858-4607
Practice Address - Street 1:1900 N HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:WHITLEY CITY
Practice Address - State:KY
Practice Address - Zip Code:42653-4119
Practice Address - Country:US
Practice Address - Phone:606-376-5391
Practice Address - Fax:888-960-2041
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006069363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000669616OtherANTHEM
KY7100078770Medicaid
KY000000669616OtherANTHEM