Provider Demographics
NPI:1407012842
Name:DR JENNIFER MUNSON KIDNEY CARE SPECIALIST LLC
Entity Type:Organization
Organization Name:DR JENNIFER MUNSON KIDNEY CARE SPECIALIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-291-9100
Mailing Address - Street 1:11397 TERWILLINGERS CREEK DRIVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45249
Mailing Address - Country:US
Mailing Address - Phone:859-291-9100
Mailing Address - Fax:859-291-9101
Practice Address - Street 1:11397 TERWILLINGERS CREEK DRIVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249
Practice Address - Country:US
Practice Address - Phone:859-291-9100
Practice Address - Fax:859-291-9101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty