Provider Demographics
NPI:1598707291
Name:HIGNITE, JODIE LYNN (APRN)
Entity Type:Individual
Prefix:
First Name:JODIE
Middle Name:LYNN
Last Name:HIGNITE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JODIE
Other - Middle Name:LYNN
Other - Last Name:CARVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-0909
Mailing Address - Country:US
Mailing Address - Phone:502-629-6000
Mailing Address - Fax:502-629-5865
Practice Address - Street 1:231 EAST CHESTNUT STREET
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1821
Practice Address - Country:US
Practice Address - Phone:502-629-6000
Practice Address - Fax:502-629-5865
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3002832363L00000X, 363LP0222X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100006250Medicaid
IN200344740Medicaid
KYK057910Medicare PIN
KY7100006250Medicaid
IN200344740Medicaid
KYP400018526Medicare PIN