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Individual

JENNIFER A BOOTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1600 BRECKENRIDGE ST, OWENSBORO, KY 42303-1055
(270) 686-7744
Mailing address
1501 BRECKENRIDGE ST, OWENSBORO, KY 42303-1054
(270) 686-7747
(270) 926-9862

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3008566
KY
363LF0000X
Family Nurse Practitioner
Primary
3008566
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1497167472
KY
Enumeration date
05/27/2014
Last updated
07/21/2022
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