Healthcare Provider Details

I. General information

NPI: 1033144191
Provider Name (Legal Business Name): TRAMPAS S NOLAN ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 W TENNESSEE AVE
PINEVILLE KY
40977-1737
US

IV. Provider business mailing address

222 W TENNESSEE AVE
PINEVILLE KY
40977-1737
US

V. Phone/Fax

Practice location:
  • Phone: 606-654-6210
  • Fax: 606-654-6220
Mailing address:
  • Phone: 606-654-6210
  • Fax: 606-654-6220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3004312
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: