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General NPI Number Information
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NPI Number | 1194156596
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Entity Type | Organization
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Legal Business Name | WESTERN KENTUCKY BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 12/10/2013
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Last Update Date | 08/18/2023
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Provider Practice Location Address
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Address Line | 2363 LYCE DUNCAN RD
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City | DIXON
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State | KY
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Zip | 42409-9761
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Country | US
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Telephone | 270-213-3635
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Fax | 270-213-5015
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Provider Business Mailing Address
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Address Line | 2363 LYCE DUNCAN RD
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City | DIXON
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State | KY
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Zip | 42409-9761
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Country | US
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Telephone | 270-213-0094
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Fax | 270-693-9499
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Authorized Official
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Title or Position | OWNER
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Name | REGINA ELISE ROBISON
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Credential | APRN
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Telephone | 270-213-3635
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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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