Provider Demographics
NPI:1235148750
Name:CATLETT, JENNIFER B (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:B
Last Name:CATLETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 LONGEST AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40204-2127
Mailing Address - Country:US
Mailing Address - Phone:502-216-4677
Mailing Address - Fax:
Practice Address - Street 1:151 N EAGLE CREEK DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1889
Practice Address - Country:US
Practice Address - Phone:859-523-2526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY35800207V00000X
IN01060265A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY50021288OtherPASSPORT - WS
KY00533079OtherMEDICARE - WSPEC
KY7100073860OtherMEDICAID - KY - WS
KY100007OtherSIHO - NCMA
KY3691798000OtherPASSPORT ADVTG - WS
KY000000596335OtherANTHEM - WS
KY000023034WOtherHUMANA -WS
IN200526190Medicaid
KY000000596335OtherANTHEM - WS
KY100007OtherSIHO - NCMA
IN082240CMedicare PIN