Individual
JENNIFER NICOLE PROFFITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
197 WILL WALKER ROAD, COLUMBIA, KY 42728-7436
(270) 384-9981
(270) 384-9989
Mailing address
PO BOX 1080, BURKESVILLE, KY 42717-1080
(270) 864-1472
(270) 864-1693
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3005691
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11883584
CAQH
—
05
—
7100056920
—
KY
Enumeration date
08/13/2008
Last updated
05/12/2023
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