Provider Demographics
NPI:1215668280
Name:MCPEEK, JENNIFER KAY (APRN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KAY
Last Name:MCPEEK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 MONARCH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1820
Mailing Address - Country:US
Mailing Address - Phone:859-296-3141
Mailing Address - Fax:859-296-3144
Practice Address - Street 1:1030 MONARCH ST STE 100
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1820
Practice Address - Country:US
Practice Address - Phone:859-296-3141
Practice Address - Fax:859-296-3144
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-21
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017869363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty