Healthcare Provider Details

I. General information

NPI: 1932860129
Provider Name (Legal Business Name): ROBYN BRIANNA MCCARTY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2022
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030A BURLEW BLVD
OWENSBORO KY
42303-1735
US

IV. Provider business mailing address

PO BOX 1919
OWENSBORO KY
42302-1919
US

V. Phone/Fax

Practice location:
  • Phone: 270-926-2273
  • Fax: 270-684-3212
Mailing address:
  • Phone: 270-926-2273
  • Fax: 270-684-3212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3016924
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: