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NPI Code Detail

MEDICARE: DR. HERBERT A. COUCH DNP, APRN, NP-C

MEDICARE: DR. HERBERT A. COUCH DNP, APRN, NP-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 Practitioner3006089KY
2363L00000XNurse Practitioner30006089KY

General Provider Information

NPI Number : 1619100765
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HERBERT A. COUCH DNP, APRN, NP-C
Provider Business Mailing Address
First Line : 638 E COLLEGE AVE
Second Line : SUITE B
City : STANTON
State : KY
Zip : 40380-2363
Country : US
Telephone Number : 606-318-3500
Fax Number : 606-318-3503
Provider Business Practice Location Address
First Line : 638 E COLLEGE AVE
Second Line : SUITE B
City : STANTON
State : KY
Zip : 40380-2363
Country : US
Telephone Number : 606-318-3500
Fax Number : 606-318-3503
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2009
Last Update Date : 09/23/2014

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