Healthcare Provider Details

I. General information

NPI: 1730406554
Provider Name (Legal Business Name): BONNIE J FRENCH APRN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2010
Last Update Date: 11/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 JOAN AVE
ELIZABETHTOWN KY
42701-2242
US

IV. Provider business mailing address

320 JOAN AVE
ELIZABETHTOWN KY
42701-2242
US

V. Phone/Fax

Practice location:
  • Phone: 270-769-3714
  • Fax: 270-769-0335
Mailing address:
  • Phone: 270-769-3714
  • Fax: 270-769-0335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number3002236
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1117
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberKY-0840
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberKY-0799
License Number StateKY

VIII. Authorized Official

Name: MRS. BONNIE J. FRENCH
Title or Position: NURSE-THERAPIST
Credential: APRN
Phone: 270-769-3714