Healthcare for Kids & Teens, PLLC

Key facts

NPI: 1861993263
Entity type: Organization (NPI type 2)
Primary specialty: Pediatrics Physician 208000000X
License: 3004368 (KY)
Legal business name: HEALTHCARE FOR KIDS & TEENS, PLLC
Practice address: 54 Miller Pike
Lebanon, KY 40033-9248
Phone: (270) 692-9015
Fax: (270) 692-9008
NPI assigned: Feb 22, 2018
Organization subpart: No

Authorized official

Name: Jennifer Mullins, APRN
Title: Owner/Provider
Phone: (270) 692-9015

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Jennifer B Mullins, A.R.N.P. Family Nurse Practitioner · Lebanon, KY · NPI 1942307079

NPD (past)

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
18D2136788	Healthcare for Kids & Teens, PLLC 54 Miller Pike, Lebanon, KY 40033	Certificate of waiver	Sep 14, 2027

National Provider Directory

Locations

54 Miller Pike
Lebanon, KY 40033
Phone (270) 692-0052

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pediatrics Physician Group: 193400000X SINGLE SPECIALTY GROUP	208000000X	3004368	KY	Yes
General Practice Physician Group: 193400000X SINGLE SPECIALTY GROUP	208D00000X	3004368	KY

Addresses

Primary practice location

54 Miller Pike
Lebanon, KY 40033-9248

Mailing address

54 Miller Pike
Lebanon, KY 40033-9248
Phone (270) 692-9015

Other identifiers

Identifier	Type	State	Issuer
1942307079	Other	KY	PROVIDER NPI
3004368	Other	KY	APRN LICENSE
78013729	Medicaid	KY

Other providers in Lebanon, KY

Alesha Nicole Harris, OTR/L
Sara Ashley Hart
Whitney Dawn Haws
Twana D Hayes
Justin Reed Hazel, PT, DPT
Megan Ruth Hedgespeth, DO
Beverly Ann Holbert, N.P.
Patricia Mary Hollingsworth-Cecconi, O.D.
Margie Holtzclaw, LMT
Hometown Smiles Dentistry and Orthodontics

All providers in Lebanon, KY · Pediatrics Physician in Kentucky

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2018. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.