Healthcare Provider Details

I. General information

NPI: 1619762549
Provider Name (Legal Business Name): KYLIE FENTON APRN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 FLEMINGSBURG RD STE A340
MOREHEAD KY
40351-1563
US

IV. Provider business mailing address

245 FLEMINGSBURG RD STE A340
MOREHEAD KY
40351-1563
US

V. Phone/Fax

Practice location:
  • Phone: 606-207-2931
  • Fax:
Mailing address:
  • Phone: 606-207-2931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN.CNM.0019671
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number4049083
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: