Healthcare Provider Details

I. General information

NPI: 1134136179
Provider Name (Legal Business Name): DEBBIE LYNN WESLEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9919 W HIGHWAY 80
NANCY KY
42544-9003
US

IV. Provider business mailing address

9919 W HIGHWAY 80 P.O. BOX 670
NANCY KY
42544-9003
US

V. Phone/Fax

Practice location:
  • Phone: 606-636-4581
  • Fax:
Mailing address:
  • Phone: 606-636-4581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3846P
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: