MEDICARE: MS. ROBBYN GRIMSLEY JEWELL ARNP

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
1	363L00000X	Nurse Practitioner	5086P	KY

General Provider Information

NPI Number	:	1356490122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROBBYN GRIMSLEY JEWELL ARNP

Provider Business Mailing Address
First Line	:	704 COLUMBIA HWY
Second Line	:
City	:	GREENSBURG
State	:	KY
Zip	:	42743-1118
Country	:	US
Telephone Number	:	270-935-4284
Fax Number	:

Provider Business Practice Location Address
First Line	:	704 COLUMBIA HWY
Second Line	:
City	:	GREENSBURG
State	:	KY
Zip	:	42743-1118
Country	:	US
Telephone Number	:	270-935-4284
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	07/28/2023

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