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General NPI Number Information
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NPI Number | 1841700689
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Entity Type | Organization
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Legal Business Name | YOUR CARE MOBILE HEALTH PSC
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Dates
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Enumeration Date | 10/06/2017
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Last Update Date | 10/06/2017
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Provider Practice Location Address
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Address Line | 6387 US HIGHWAY 150 E
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City | STANFORD
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State | KY
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Zip | 40484-9748
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Country | US
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Telephone | 606-669-1542
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Fax |
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Provider Business Mailing Address
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Address Line | 6387 US HIGHWAY 150 E
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City | STANFORD
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State | KY
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Zip | 40484-9748
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Country | US
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Telephone | 606-669-1542
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | JACKIE NOLAND
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Credential | ARNP
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Telephone | 606-669-1542
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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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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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