OrganizationActive
Healthcare for Kids & Teens, PLLC
NPI 1861993263 · Pediatrics Physician · Lebanon, KY
Provider details
- NPI number
- 1861993263
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jennifer Mullins, Owner/Provider(270) 692-9015
- License
- 3004368 (KY)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
54 Miller Pike
Lebanon, KY 40033-9248
Phone: (270) 692-9015
Fax: (270) 692-9008
Approximate (ZIP-level) locationGet directions
Mailing address
54 Miller Pike
Lebanon, KY 40033-9248
Registry dates
- Enumerated
- 2018-02-22
- Last updated
- 2018-02-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.