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General NPI Number Information
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NPI Number | 1124385257
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Entity Type | Individual
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Provider Name | ARDITH ELAINE O'ROURKE MSN, NP-C
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Gender | Female
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Dates
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Enumeration Date | 04/13/2012
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Last Update Date | 04/27/2016
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Provider Practice Location Address
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Address Line | 57 J.E. ELLIS ROAD
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City | MADISONVILLE
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State | KY
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Zip | 42431
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Country | US
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Telephone | 270-249-6041
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Fax | 270-249-3204
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Provider Business Mailing Address
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Address Line | 57 J.E.ELLIS ROAD WARRIOR COAL, LLC
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City | MADISONVILLE
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State | KY
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Zip | 42431
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Country | US
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Telephone | 270-249-6041
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Fax | 270-249-3204
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3007408
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License Number State | KY
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