Healthcare Provider Details

I. General information

NPI: 1306872643
Provider Name (Legal Business Name): MARCIA A. POLLEY A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 08/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7139 STATE ROUTE 56 EAST
SEBREE KY
42455-0009
US

IV. Provider business mailing address

7139 STATE ROUTE 56 EAST P O BOX 9
SEBREE KY
42455-0009
US

V. Phone/Fax

Practice location:
  • Phone: 270-835-0145
  • Fax: 270-835-0086
Mailing address:
  • Phone: 270-835-0145
  • Fax: 270-835-0145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1037912
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: