Individual
JESSICA A HENNINGSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9301 DAYFLOWER ST STE 100, PROSPECT, KY 40059-7585
(502) 326-8588
(502) 326-8589
Mailing address
9301 DAYFLOWER ST STE 100, PROSPECT, KY 40059-7585
(502) 326-8588
(502) 326-8589
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
363A00000X
KY
363A00000X
Physician Assistant
SP561493
OH
363AM0700X
Medical Physician Assistant
50.004805RX
OH
Other
Enumeration date
10/05/2016
Last updated
03/11/2025
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