Healthcare Provider Details

I. General information

NPI: 1144971748
Provider Name (Legal Business Name): STEPHANIE WORLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2022
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2157 S HIGHWAY 27
STEARNS KY
42647-6297
US

IV. Provider business mailing address

574 WORLEY HILL TOP RD
STEARNS KY
42647-6280
US

V. Phone/Fax

Practice location:
  • Phone: 606-376-9700
  • Fax: 606-376-9703
Mailing address:
  • Phone: 606-516-0064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3017282
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: