Healthcare Provider Details

I. General information

NPI: 1568290302
Provider Name (Legal Business Name): RACHEL NICOLE HOPKINS MUNCY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2024
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 E PARRISH AVE STE 101B
OWENSBORO KY
42303-1450
US

IV. Provider business mailing address

2315 WOODSTONE CT
UTICA KY
42376-9076
US

V. Phone/Fax

Practice location:
  • Phone: 270-683-3232
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4025136
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: