Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 44553 | KY |
NPI | 1285897637 |
---|---|
Provider Name | Jennifer M Brey |
First Address | Chicago, IL 60677-6351 |
Second Address | Louisville, KY 40207-4729 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2008 |
Last Update Date | 12/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000729177 | ANTHEM - COOL (01) | KY |
000057121QD | HUMANA - COOL (01) | KY |
128185 | SIHO - COOL (01) | KY |
201034640 | (05) | IN |
50036336 | PASSPORT - COOL (01) | KY |
7100176450 | (05) | KY |