Healthcare Provider Details

I. General information

NPI: 1376571885
Provider Name (Legal Business Name): NICHOLAS H SETTLES PAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 08/09/2022
Certification Date: 06/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 TRIPLETT ST SUITE 2100
OWENSBORO KY
42303-3104
US

IV. Provider business mailing address

2330 FALCON CT
OWENSBORO KY
42303-9328
US

V. Phone/Fax

Practice location:
  • Phone: 270-926-7320
  • Fax: 270-926-7302
Mailing address:
  • Phone: 270-231-0420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberKYPA925
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA925
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number10000826A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: