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General NPI Number Information
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NPI Number | 1902242613
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Entity Type | Organization
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Legal Business Name | NANCY FAMILY PRACTICE, PLLC
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Dates
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Enumeration Date | 05/21/2013
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Last Update Date | 07/06/2019
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Provider Practice Location Address
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Address Line | 7238 W HIGHWAY 80
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City | NANCY
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State | KY
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Zip | 42544-8752
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Country | US
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Telephone | 606-636-4214
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Fax | 606-636-4215
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Provider Business Mailing Address
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Address Line | PO BOX 100 7238 WEST HWY 80
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City | NANCY
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State | KY
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Zip | 42544-0100
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Country | US
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Telephone | 606-636-4214
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Fax | 606-636-4215
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Authorized Official
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Title or Position | COO/CO-OWNER/PROVIDER
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Name | MRS. DIANA L WILLIAMSON
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Credential | APRN FNP-C
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Telephone | 606-636-4214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 900330
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License Number State | KY
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