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General NPI Number Information
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NPI Number | 1679195630
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Entity Type | Individual
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Provider Name | PETER JEROME YOUMANS III APRN
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Gender | Male
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Dates
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Enumeration Date | 05/13/2020
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Last Update Date | 08/10/2025
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Provider Practice Location Address
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Address Line | 101 DENNIS SANDLIN MD CV
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City | HAZARD
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State | KY
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Zip | 41701-1559
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Country | US
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Telephone | 606-439-2111
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Fax |
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Provider Business Mailing Address
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Address Line | 72 BUCKHORN CLINIC RD
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City | BUCKHORN
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State | KY
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Zip | 41721-8936
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Country | US
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Telephone | 606-398-7141
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Fax |
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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 | 3014605
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License Number State | KY
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