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NPI Code Detail

MEDICARE: CHASITY PENDLETON APRN, FNP-C

MEDICARE: CHASITY PENDLETON APRN, FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner363LF0000XKY

General Provider Information

NPI Number : 1194586396
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHASITY PENDLETON APRN, FNP-C
Provider Business Mailing Address
First Line : PO BOX 1080
Second Line :
City : BURKESVILLE
State : KY
Zip : 42717-1080
Country : US
Telephone Number : 270-858-6655
Fax Number : 270-858-4027
Provider Business Practice Location Address
First Line : 593 E MAIN ST
Second Line :
City : FRANKFORT
State : KY
Zip : 40601-2332
Country : US
Telephone Number : 502-223-0308
Fax Number : 502-227-5764
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2024
Last Update Date : 01/16/2024

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