Healthcare Provider Details

I. General information

NPI: 1649492026
Provider Name (Legal Business Name): HOSPICE OF HOPE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 KENTON STATION DR
MAYSVILLE KY
41056-9616
US

IV. Provider business mailing address

909 KENTON STATION DR
MAYSVILLE KY
41056-9616
US

V. Phone/Fax

Practice location:
  • Phone: 606-759-4050
  • Fax: 606-759-1207
Mailing address:
  • Phone: 606-759-4050
  • Fax: 606-759-1207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number3765P
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 5
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DEREK SHAWN FLAUGHER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 606-759-4050