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General NPI Number Information
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NPI Number | 1972983559
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Entity Type | Individual
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Provider Name | AMY WHEATLEY APRN
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Gender | Female
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Dates
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Enumeration Date | 06/09/2015
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Last Update Date | 05/29/2024
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Provider Practice Location Address
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Address Line | 134 MAIN AVE
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City | NAZARETH
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State | KY
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Zip | 40048-1377
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Country | US
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Telephone | 502-331-4551
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 237
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City | NAZARETH
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State | KY
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Zip | 40048-0237
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Country | US
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Telephone | 270-699-6118
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3009420
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License Number State | KY
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