| Doctor Name: | JENNIFER NICOLE PROFFITT |
| NPI Number: | 1760638456 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | 5691P |
| Business Practice Address: | 710 N Main St Tompkinsville, KY - 421671130 |
| Business Phone Number: | 2704878667 |
| Business Fax Number: | 2704879505 |
| Mailing Address: | 710 N Main St, TOMPKINSVILLE |
| State: | KY |
| Postal Code: | 421671130 |
| Phone Number: | 2704878667 |
| Fax Number: | 2704879505 |
| NPI Enumeration Date: | 08/13/2008 |
| NPI Last Update Date: | 03/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 5691P |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |