Individual
JEANNINE MARIE PERRENOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
329 FLOYD DR, CARROLLTON, KY 41008-8261
(502) 732-3270
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 253-1035
(502) 253-1037
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
02981
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000520560
ANTHEM
KY
01
—
2848976000
PASSPORT ADVANTAGE
KY
01
—
50014768
PASSPORT
KY
05
—
6412794700
—
KY
Enumeration date
10/10/2006
Last updated
12/07/2020
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