Provider Demographics
NPI:1669875241
Name:DANIEL, JENNIFER C (APRN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:C
Last Name:DANIEL
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 1:217 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-1823
Mailing Address - Country:US
Mailing Address - Phone:859-239-5860
Mailing Address - Fax:859-239-5879
Practice Address - Street 1:640 E LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-1719
Practice Address - Country:US
Practice Address - Phone:859-236-1250
Practice Address - Fax:859-236-9776
Is Sole Proprietor?:No
Enumeration Date:2014-09-26
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008963363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner