Provider Demographics
NPI:1851864805
Name:BAIER, JENNAH
Entity type:Individual
Prefix:
First Name:JENNAH
Middle Name:
Last Name:BAIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10292 STATE ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:ARGILLITE
Mailing Address - State:KY
Mailing Address - Zip Code:41121-8486
Mailing Address - Country:US
Mailing Address - Phone:606-831-0981
Mailing Address - Fax:606-831-0981
Practice Address - Street 1:336 29TH ST STE 203
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-1932
Practice Address - Country:US
Practice Address - Phone:606-225-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-02
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1158238163WP0808X
KY4012489363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health