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General NPI Number Information
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NPI Number | 1982016630
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Entity Type | Individual
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Provider Name | JOE BRIAN MIDDLETON APRN-FNP
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Gender | Male
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Dates
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Enumeration Date | 05/29/2014
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Last Update Date | 03/10/2023
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Provider Practice Location Address
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Address Line | 310 N L ROGERS WELLS BLVD
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City | GLASGOW
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State | KY
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Zip | 42141-1300
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Country | US
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Telephone | 270-659-5555
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Fax | 270-659-5566
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Provider Business Mailing Address
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Address Line | 1774 SPILLMAN RD
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City | CAVE CITY
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State | KY
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Zip | 42127-9128
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Country | US
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Telephone | 270-537-5451
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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 | 3008673
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3008673
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License Number State | KY
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