Provider Demographics
NPI:1609061910
Name:PEAVEY, JENNIFER E (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:E
Last Name:PEAVEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 BOB WHITE WAY
Mailing Address - Street 2:APT. A
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-5146
Mailing Address - Country:US
Mailing Address - Phone:270-710-1700
Mailing Address - Fax:270-651-4751
Practice Address - Street 1:105 BOB WHITE WAY
Practice Address - Street 2:APT. A
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-5146
Practice Address - Country:US
Practice Address - Phone:270-710-1700
Practice Address - Fax:270-651-4751
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program