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General NPI Number Information
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NPI Number | 1902297625
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Entity Type | Organization
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Legal Business Name | WOMEN'S HEALTH CENTER OF CENTRAL KENTUCKY, PLLC
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Dates
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Enumeration Date | 02/17/2015
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Last Update Date | 06/16/2015
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Provider Practice Location Address
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Address Line | 1858 OLD LEBANON RD
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-9663
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Country | US
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Telephone | 270-469-4496
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Fax | 270-469-0095
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Provider Business Mailing Address
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Address Line | 1858 OLD LEBANON RD
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-9663
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Country | US
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Telephone | 270-469-4496
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Fax | 270-469-0095
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Authorized Official
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Title or Position | MANAGER/OWNER
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Name | MRS. LESLIE DENISE SIMMONS
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Credential | APRN
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Telephone | 270-469-4496
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 3006407
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License Number State | KY
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