Jayne Ellen Kendle, APRN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

3011747 Issued in KY

Practice address

105 Elk Fork Rd
Elkton, KY 42220-7218

Phone

(270) 265-2574

Fax

(270) 265-3098

NPI assigned

Feb 15, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1518652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1790285856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 OLIVE CREEK RD",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420256231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 ELK FORK RD",
            "city": "ELKTON",
            "state": "KY",
            "postal_code": "422207218",
            "telephone_number": "270-265-2574",
            "fax_number": "270-265-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDLE",
        "first_name": "JAYNE",
        "middle_name": "ELLEN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-15",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "KY",
            "license": "3011747",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "23643",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Katherine Denise Knight, OTR/L
• Sara Lee, PHARMD
• Diana Leszczewicz, APRN
• Lela Livingston, APRN, FNP-C
• LK Mansfield LLC

• Pediatric Nurse Practitioner in Elkton, KY
• Providers in Elkton, KY by specialty
• Pediatric Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.