Healthcare Provider Details

I. General information

NPI: 1659659274
Provider Name (Legal Business Name): KEVIN B SCALF APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2011
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MEDICAL CENTER DR
HAZARD KY
41701-9421
US

IV. Provider business mailing address

100 MEDICAL CENTER DR
HAZARD KY
41701-9421
US

V. Phone/Fax

Practice location:
  • Phone: 606-439-1331
  • Fax: 606-439-6682
Mailing address:
  • Phone: 606-439-1331
  • Fax: 606-439-6682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3007037
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: