Provider Demographics
NPI:1306485693
Name:ISENHOWER, JATAUN L (APRN)
Entity type:Individual
Prefix:
First Name:JATAUN
Middle Name:L
Last Name:ISENHOWER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 ANDREA ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-5853
Mailing Address - Country:US
Mailing Address - Phone:270-495-6482
Mailing Address - Fax:270-495-6479
Practice Address - Street 1:1325 ANDREA ST STE 100
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-5853
Practice Address - Country:US
Practice Address - Phone:270-495-6482
Practice Address - Fax:270-495-6479
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-03
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3014076363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily