Provider Demographics
NPI:1588988075
Name:JENNINGS, ABIGAIL LEIGH (MD)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:LEIGH
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:222 22ND AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1870
Mailing Address - Country:US
Mailing Address - Phone:629-255-2027
Mailing Address - Fax:629-255-4218
Practice Address - Street 1:3901 CENTRAL PIKE STE 251
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-3421
Practice Address - Country:US
Practice Address - Phone:629-255-2027
Practice Address - Fax:629-255-4218
Is Sole Proprietor?:No
Enumeration Date:2010-03-26
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN49361208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ001525Medicaid