=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720642275
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NANCYE ANNE BROWNING
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/30/2019
-----------------------------------------------------
Last Update Date | 04/30/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 346 S MAIN ST
-----------------------------------------------------
City | LEITCHFIELD
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42754-1428
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-230-1777
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1411 LEVERING ST
-----------------------------------------------------
City | LOUISVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40208-2237
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 502-599-1419
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 105081
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------