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General NPI Number Information
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NPI Number | 1154076941
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Entity Type | Organization
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Legal Business Name | KENTUCKY FAMILY PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 02/20/2022
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Last Update Date | 03/04/2022
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Provider Practice Location Address
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Address Line | 1374 HIGHWAY 192 E STE 400
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City | LONDON
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State | KY
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Zip | 40741-3123
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Country | US
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Telephone | 606-770-5454
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Fax | 606-770-5455
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Provider Business Mailing Address
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Address Line | PO BOX 3261
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City | LONDON
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State | KY
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Zip | 40743-3261
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Country | US
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Telephone | 606-770-5454
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | ANGELA CAIN
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Credential | APRN
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Telephone | 606-770-5454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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