Healthcare Provider Details

I. General information

NPI: 1831101211
Provider Name (Legal Business Name): JULIE F ROYSTER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 US HIGHWAY 60 W
LEDBETTER KY
42058-9557
US

IV. Provider business mailing address

PO BOX 9150
PADUCAH KY
42002-9150
US

V. Phone/Fax

Practice location:
  • Phone: 270-898-1388
  • Fax: 270-898-1389
Mailing address:
  • Phone: 270-744-9600
  • Fax: 270-744-8642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4010P
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: