Individual
STACEY ELIZABETH MERRITT-JENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6200 DUTCHMANS LN, LOUISVILLE, KY 40205-3271
(502) 456-6200
(502) 456-6655
Mailing address
6200 DUTCHMANS LN, LOUISVILLE, KY 40205-3271
(502) 456-6200
(502) 456-6655
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01041029A
IN
207P00000X
Emergency Medicine Physician
Primary
28829
KY
207PH0002X
Hospice and Palliative Medicine (Emergency Medicine) Physician
01041029A
IN
207PH0002X
Hospice and Palliative Medicine (Emergency Medicine) Physician
28829
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000185657
ANTHEM
KY
01
—
1124516
PASSPORT
KY
05
—
200009620
—
IN
01
—
2437324000
PASSPORT ADVANTAGE
KY
05
—
64018880
—
KY
Enumeration date
08/21/2006
Last updated
02/02/2026
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