Provider Demographics
NPI:1851511158
Name:ERNST-PIERSON, JENNIFER MARIE (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIE
Last Name:ERNST-PIERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:MARIE
Other - Last Name:ERNST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-578-3400
Mailing Address - Fax:859-957-0055
Practice Address - Street 1:334 THOMAS MORE PKWY
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3464
Practice Address - Country:US
Practice Address - Phone:859-578-3400
Practice Address - Fax:859-957-0055
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35088121208000000X, 207R00000X
KY41884208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP00839872OtherRAILROAD MEDICARE
KY7100018350Medicaid
IN200867010Medicaid
P00667498OtherRAILROAD MEDICARE
OH2748192Medicaid
KY7100018350Medicaid
KY0672732Medicare PIN
P00667498OtherRAILROAD MEDICARE