Healthcare Provider Details

I. General information

NPI: 1730701053
Provider Name (Legal Business Name): MICHAEL C PARTIN DNP, APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2020
Last Update Date: 03/04/2024
Certification Date: 03/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 OFFICE PARK DR
COLUMBIA KY
42728-1270
US

IV. Provider business mailing address

404 W FRAZIER AVE
COLUMBIA KY
42728-1687
US

V. Phone/Fax

Practice location:
  • Phone: 270-384-3939
  • Fax: 270-384-3940
Mailing address:
  • Phone: 270-250-4242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3014954
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1136923
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: