BLUEGRASS REGIONAL HEALTHCARE NPI 1609994789

NPI Information

NPI: 1609994789
Provider Name: BLUEGRASS REGIONAL HEALTHCARE
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
1307 N MAIN ST
BEAVER DAM, KY
ZIP 42320
Phone: (270) 274-9222
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BLUEGRASS REGIONAL HEALTHCARE is a family nurse practitioner in Beaver Dam, KY. BLUEGRASS REGIONAL HEALTHCARE NPI is 1609994789. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1307 N MAIN ST
BEAVER DAM, KY
ZIP 42320-957
Phone: (270) 274-9222
Fax: (270) 274-0696

The provider's authorized official is Susan Matthews .
The authorized official title is Owner, Provider and has the following contact phone number (270) 274-9222.

The enumeration date for this NPI number is 3/27/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	2835P	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	78006764	MEDICAID	KENTUCKY
2	2835P	OTHER	KENTUCKY	LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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