Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0000X | Nurse Practitioner - Neonatal | 28133882A | IN |
Y | 363LN0000X | Nurse Practitioner - Neonatal | 3010497 | KY |
N | 363LN0000X | Nurse Practitioner - Neonatal | 71008688A | IN |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 3010497 | KY |
NPI | 1225481054 |
---|---|
Provider Name | Mrs. Jennifer Marie Hockensmith |
First Address | Chicago, IL 60677-6879 |
Second Address | Louisville, KY 40202-1821 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2016 |
Last Update Date | 03/02/2021 |