Individual
DR. JENNIFER LYNN WALDEN-FAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9517 US HIGHWAY 42 STE 410, PROSPECT, KY 40059-9237
(502) 587-0521
(502) 587-3893
Mailing address
9517 US HIGHWAY 42 STE 410, PROSPECT, KY 40059-9237
(502) 587-0521
(502) 587-3893
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35020
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841211174
NPI
KY
05
—
64012180
—
KY
Enumeration date
07/21/2006
Last updated
12/07/2021
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