Provider Demographics
NPI:1497634729
Name:KINLAW, JENNIFER BASS (PMHNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BASS
Last Name:KINLAW
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3530 INDIAN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:TN
Mailing Address - Zip Code:38478-7385
Mailing Address - Country:US
Mailing Address - Phone:931-309-5076
Mailing Address - Fax:
Practice Address - Street 1:3530 INDIAN CREEK RD
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:TN
Practice Address - Zip Code:38478-7385
Practice Address - Country:US
Practice Address - Phone:931-309-5076
Practice Address - Fax:931-309-5076
Is Sole Proprietor?:No
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program