Provider Demographics
NPI:1629610878
Name:WARFIELD, JENNIE LEE
Entity Type:Individual
Prefix:
First Name:JENNIE
Middle Name:LEE
Last Name:WARFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 ALLISON CIR
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-2926
Mailing Address - Country:US
Mailing Address - Phone:859-539-2695
Mailing Address - Fax:
Practice Address - Street 1:121 ALLISON CIR
Practice Address - Street 2:
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-2926
Practice Address - Country:US
Practice Address - Phone:859-539-2695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider