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General NPI Number Information
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NPI Number | 1609586122
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Entity Type | Organization
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Legal Business Name | OHANA CARE OF LAKE CUMBERLAND, LLC
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Dates
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Enumeration Date | 11/28/2022
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 310 W COLUMBIA ST
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City | SOMERSET
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State | KY
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Zip | 42501-1618
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Country | US
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Telephone | 606-331-5328
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Fax | 859-207-6700
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Provider Business Mailing Address
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Address Line | 650 S HIGHWAY 27 # 308
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City | SOMERSET
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State | KY
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Zip | 42501-3501
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Country | US
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Telephone | 606-331-5328
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Fax | 859-207-6700
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Authorized Official
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Title or Position | OWNER/APRN
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Name | SARA BETH PENCE
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Credential |
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Telephone | 606-331-5328
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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 |
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License Number State |
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