Provider Demographics
NPI:1962873349
Name:TRAUTWEIN, JENNIE EVANS (APRN)
Entity type:Individual
Prefix:
First Name:JENNIE
Middle Name:EVANS
Last Name:TRAUTWEIN
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 1:531 WELLINGTON WAY FL 2
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1482
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:531 WELLINGTON WAY FL 2
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1482
Practice Address - Country:US
Practice Address - Phone:859-562-1738
Practice Address - Fax:859-323-5861
Is Sole Proprietor?:No
Enumeration Date:2015-10-12
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3009525363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily