MEDICARE: CARRIE BRANTLEY RN

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
1	163W00000X	Registered Nurse	1179082	KY

General Provider Information

NPI Number	:	1861347676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE BRANTLEY RN

Provider Business Mailing Address
First Line	:	6300 THOMAS CT
Second Line	:
City	:	PROSPECT
State	:	KY
Zip	:	40059-7515
Country	:	US
Telephone Number	:	502-394-6350
Fax Number	:

Provider Business Practice Location Address
First Line	:	6300 THOMAS CT
Second Line	:
City	:	PROSPECT
State	:	KY
Zip	:	40059-7515
Country	:	US
Telephone Number	:	502-394-6350
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2026
Last Update Date	:	02/27/2026

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Directions to “ CARRIE BRANTLEY RN” Practice Location

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