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
Phone: (502) 243-3161
Fax: (502) 243-3164
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891934980 | NPPES |
| Kentucky | Other | 000000650401 | ANTHEM |
| Kentucky | Other | 50027705 | ANTHEM |
| Kentucky | MEDICAID | 7100104670 | ANTHEM |
| Kentucky | Other | P00854282 | ANTHEM |
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