Healthcare Provider Details

I. General information

NPI: 1407187941
Provider Name (Legal Business Name): HOPE FAMILY CLINIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2010
Last Update Date: 04/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 MAYSVILLE RD SUITE 2
MT STERLING KY
40353-9317
US

IV. Provider business mailing address

506 N MAYSVILLE ROAD SUITE 2
MT STERLING KY
40353-9679
US

V. Phone/Fax

Practice location:
  • Phone: 859-432-8168
  • Fax: 859-432-8163
Mailing address:
  • Phone: 859-432-8168
  • Fax: 859-432-8163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. BRENDA J PITTMAN
Title or Position: OWNER/OPERATOR
Credential: ARNP
Phone: 859-432-8168