Provider Demographics
NPI:1679501308
Name:BUCHANAN, JENNA LYNN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JENNA
Middle Name:LYNN
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:LYNN
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:510 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3554
Mailing Address - Country:US
Mailing Address - Phone:812-282-1888
Mailing Address - Fax:812-218-9318
Practice Address - Street 1:2401 REGENCY RD. STE. 101
Practice Address - Street 2:ACCESS WELLNESS GROUP
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503
Practice Address - Country:US
Practice Address - Phone:859-309-0309
Practice Address - Fax:859-309-0914
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2015-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007808363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000056294OtherANTHEM GROUP
000000806055OtherANTHEM
1487872636OtherNPI GROUP NUMBER (ARNP)
KY184607OtherMEDICARE GROUP NUMBER
KY7100238160Medicaid
KYCK2274OtherRAILROAD MEDICARE GROUP
KY78903689OtherKY MEDICAID ARNP GROUP
KYP01161549OtherRAILROAD MEDICARE
KY6764OtherMEDICARE GROUP
KY184607OtherMEDICARE GROUP NUMBER