BOWLING GREEN PSYCHIATRY NPI 1861099269

NPI Information

NPI: 1861099269
Provider Name: BOWLING GREEN PSYCHIATRY
Classification: Nurse Practitioner - 363LP0808X
Specialization: Psychiatric/Mental Health
Entity Type: Organization
Address: 730 FAIRVIEW AVE STE B3
BOWLING GREEN, KY
ZIP 42101
Phone: (270) 715-0665

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NPI Details

BOWLING GREEN PSYCHIATRY is a psychiatric/mental health nurse practitioner in Bowling Green, KY. BOWLING GREEN PSYCHIATRY NPI is 1861099269. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

730 FAIRVIEW AVE STE B3
BOWLING GREEN, KY
ZIP 42101-365
Phone: (270) 715-0665
Fax: (270) 550-2008

The provider's authorized official is Daltrey Anne Tyree .
The authorized official title is Owner, Provider and has the following contact phone number (270) 421-3397.

The enumeration date for this NPI number is 10/8/2020 and was last updated on 10/19/2025.

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	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			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	7100697650	MEDICAID	KENTUCKY

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: 11/21/2025

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