Provider Demographics
NPI:1346403458
Name:JOHNER, JENNIFER THERESA (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:THERESA
Last Name:JOHNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:THERESA
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:331 RIDGEWAY RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-2341
Mailing Address - Country:US
Mailing Address - Phone:859-338-4155
Mailing Address - Fax:
Practice Address - Street 1:331 RIDGEWAY RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-2341
Practice Address - Country:US
Practice Address - Phone:859-338-4155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY43804207L00000X
GA64840207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology