Individual
DR. JENNIFER WALTON BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2501 KENTUCKY AVE, PADUCAH, KY 42003-3813
(270) 575-2100
(812) 471-6650
Mailing address
PO BOX 139, EVANSVILLE, IN 47701-0139
(812) 471-1591
(812) 471-6650
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
38453
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000059857
ANTHEM BCBS
KY
05
—
64084593
—
KY
01
—
P00143774
RR MEDICARE
KY
Enumeration date
12/06/2005
Last updated
07/08/2007
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