Provider Demographics
NPI:1013104934
Name:RONAN, JENIFFER ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:JENIFFER
Middle Name:ANN
Last Name:RONAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 W MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-1871
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:230 W MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-1871
Practice Address - Country:US
Practice Address - Phone:859-236-3726
Practice Address - Fax:859-236-3019
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA248810207L00000X
KY47124207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology