Provider Demographics
NPI:1235395526
Name:FITZHUGH, JENNIFER ASHLEY
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ASHLEY
Last Name:FITZHUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 STEWARTS LN N
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-8825
Mailing Address - Country:US
Mailing Address - Phone:859-396-9223
Mailing Address - Fax:859-236-0878
Practice Address - Street 1:409 STEWARTS LN N
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-8825
Practice Address - Country:US
Practice Address - Phone:859-396-9223
Practice Address - Fax:859-236-0878
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist