Provider Demographics
NPI:1689775850
Name:BYRNE, JENNIFER MURPHY (PT, MPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MURPHY
Last Name:BYRNE
Suffix:
Gender:F
Credentials:PT, MPT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:SUSAN
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3515 FREDERICA ST
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-6902
Mailing Address - Country:US
Mailing Address - Phone:270-684-7856
Mailing Address - Fax:270-926-4003
Practice Address - Street 1:3515 FREDERICA ST
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-6902
Practice Address - Country:US
Practice Address - Phone:270-684-7856
Practice Address - Fax:270-926-4003
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004945225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY5025605Medicare PIN