Jetta Nicole Pennington, is a
Nurse Practitioner - Family based in Fisherville, Kentucky. Jetta Nicole Pennington is licensed to practice in Kentucky (license number 4014463) and her current practice location is
2303 Champion Hill Pl, Fisherville, Kentucky. She can be reached at her office (for appointments etc.) via phone at
(606) 831-1553.
NPI number for Jetta Nicole Pennington is 1790555761 and her current mailing address is 2303 Champion Hill Pl, Fisherville, Kentucky. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1790555761.
Provider's Profile
Full Name | Jetta Nicole Pennington |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 2303 Champion Hill Pl, Fisherville, Kentucky |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1790555761
- Provider Enumeration Date: 01/02/2024
- Last Update Date: 01/02/2024
Medical Identifiers
Medical identifiers for Jetta Nicole Pennington such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1790555761 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | 4014463 (Kentucky) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jetta Nicole Pennington is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jetta Nicole Pennington, 2303 Champion Hill Pl, Fisherville, KY 40023-8801 Ph: (606) 831-1553 | Jetta Nicole Pennington, 2303 Champion Hill Pl, Fisherville, KY 40023-8801 Ph: (606) 831-1553 |
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