Provider Demographics
NPI:1700877552
Name:HAMILTON-CAGLE, JENNIFER (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:HAMILTON-CAGLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:HAMILTON-CAGLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:305 S 8TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2404
Mailing Address - Country:US
Mailing Address - Phone:270-753-4616
Mailing Address - Fax:270-767-3623
Practice Address - Street 1:305 S 8TH ST STE A
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2404
Practice Address - Country:US
Practice Address - Phone:270-753-4616
Practice Address - Fax:270-767-3623
Is Sole Proprietor?:No
Enumeration Date:2005-11-01
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3003438363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY00354OtherMEDICARE-GROUP
KY000000047516OtherANTHEM
KY00354002Medicare PIN
KYP34564Medicare UPIN