=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811979685
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ISABELLA BEATRICE NYAN MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/17/2005
-----------------------------------------------------
Last Update Date | 02/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 245 FLEMINGSBURG RD STE A340
-----------------------------------------------------
City | MOREHEAD
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40351-1015
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-207-2931
-----------------------------------------------------
Fax | 606-783-0964
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | P O BOX 40 226 MEDICAL PLAZA LANE
-----------------------------------------------------
City | WHITESBURG
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41858
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-633-4823
-----------------------------------------------------
Fax | 606-633-1874
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 30599
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------