Fortwengler, Jessica L

Fortwengler, Jessica L is an individual health care provider with primary practice located at 6580 Kenwood Crossing Road , Crestwood KY 40014. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Fortwengler, Jessica L can be contacted via phone (502) 243-3161.

Contact Information

Primary practice address
6580 Kenwood Crossing Road Crestwood KY 40014
Fax: (502) 243-3164
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 42398 Kentucky

Profile Details

NPI number 1891934980
LBN Legal business name Fortwengler, Jessica L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 12th, 2009
Last updated Jan 17th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1891934980 NPPES
Kentucky Other 000000650401 ANTHEM
Kentucky Other 50027705 ANTHEM
Kentucky MEDICAID 7100104670 ANTHEM
Kentucky Other P00854282 ANTHEM

Popular Providers