Provider Demographics
NPI:1740246354
Name:BRIGGS, JENNIFER D (APRN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:D
Last Name:BRIGGS
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 1:201 PARK ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-1708
Mailing Address - Country:US
Mailing Address - Phone:270-773-2600
Mailing Address - Fax:270-361-5101
Practice Address - Street 1:400 N DIXIE HWY
Practice Address - Street 2:
Practice Address - City:CAVE CITY
Practice Address - State:KY
Practice Address - Zip Code:42127-9546
Practice Address - Country:US
Practice Address - Phone:270-773-2600
Practice Address - Fax:270-361-5101
Is Sole Proprietor?:No
Enumeration Date:2006-04-22
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3004070363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78011129Medicaid
KY50003436OtherPASSPORT MEDICAID MGD CAR
KY78011129Medicaid
KY000000318257OtherANTHEM BCBS
KY000000318257OtherANTHEM BCBS
Q04222Medicare UPIN