Provider Demographics
NPI:1003600826
Name:JENNINGS, PAIGE KYLIE
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:KYLIE
Last Name:JENNINGS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 JEFFREYS LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH HILL
Mailing Address - State:VA
Mailing Address - Zip Code:23970-3132
Mailing Address - Country:US
Mailing Address - Phone:434-233-1214
Mailing Address - Fax:
Practice Address - Street 1:DORSEY HALL MEDICAL CENTER 9501 OLD ANNAPOLIS RD
Practice Address - Street 2:STE. 125
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042
Practice Address - Country:US
Practice Address - Phone:410-997-1063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program