Basic Information
| Provider Information | |||||||||
| NPI: | 1952742710 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOOLEY | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 635283 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452635283 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8599126500 | ||||||||
| FaxNumber: | 8594421501 | ||||||||
| Practice Location | |||||||||
| Address1: | 7370 TURFWAY RD | ||||||||
| Address2: | STE 390 | ||||||||
| City: | FLORENCE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 41042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592125125 | ||||||||
| FaxNumber: | 8592125099 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2013 | ||||||||
| LastUpdateDate: | 09/14/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | 3008263 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
ID Information
| ID | Type | State | Issuer | Description | 710026200 | 05 | KY | MEDICAID | 0092610 | 05 | OH | MEDICAID |