Healthcare Provider Details

I. General information

NPI: 1295219723
Provider Name (Legal Business Name): ROXANNE ALDERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ROXANNE BABICK

II. Dates (important events)

Enumeration Date: 09/20/2018
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 DOUBLE T LN
CORBIN KY
40701-8800
US

IV. Provider business mailing address

314 DOUBLE T LN
CORBIN KY
40701-8800
US

V. Phone/Fax

Practice location:
  • Phone: 606-595-3389
  • Fax:
Mailing address:
  • Phone: 606-280-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4059617
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number953229
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: