Individual
MISS JENCI LYN HAWTHORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MEDICAL STUDENT, MD
Contact information
Practice address
950 BRECKENRIDGE LN STE 200, LOUISVILLE, KY 40207-5929
(502) 893-6777
(502) 893-5535
Mailing address
1901 CAMPUS PL, LOUISVILLE, KY 40299-2308
(502) 253-4924
(502) 489-5750
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
60576
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390200000X
—
KY
Enumeration date
04/19/2019
Last updated
06/19/2025
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