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NPI Code Detail

MEDICARE: MATTHEW RYAN FOULKS APRN-CNP

MEDICARE: MATTHEW RYAN FOULKS APRN-CNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse Practitioner1174274KY
2363L00000XNurse Practitioner4007698KY

General Provider Information

NPI Number : 1528741139
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW RYAN FOULKS APRN-CNP
Provider Business Mailing Address
First Line : PO BOX 635283
Second Line :
City : CINCINNATI
State : OH
Zip : 45263-5283
Country : US
Telephone Number : 859-747-4446
Fax Number : 859-344-1999
Provider Business Practice Location Address
First Line : 20 MEDICAL VILLAGE DR
Second Line :
City : EDGEWOOD
State : KY
Zip : 41017-5401
Country : US
Telephone Number : 859-344-1512
Fax Number : 859-331-3698
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2023
Last Update Date : 01/06/2026

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Directions to “ MATTHEW RYAN FOULKS APRN-CNP” Practice Location

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