MEDICARE: KAYLA BETH SULLIVAN

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	363LF0000X	Family Nurse Practitioner	4048978	KY

General Provider Information

NPI Number	:	1891650115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA BETH SULLIVAN

Provider Business Mailing Address
First Line	:	1412 N RACE ST
Second Line	:
City	:	GLASGOW
State	:	KY
Zip	:	42141-3473
Country	:	US
Telephone Number	:	270-629-6333
Fax Number	:	270-629-6334

Provider Business Practice Location Address
First Line	:	1412 N RACE ST
Second Line	:
City	:	GLASGOW
State	:	KY
Zip	:	42141-3473
Country	:	US
Telephone Number	:	270-629-6333
Fax Number	:

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

Provider Enumeration Date	:	12/18/2025
Last Update Date	:	12/18/2025

Similar Medicare Providers

1740232404 — H2 REHABILITATION SERVICES OF KENTUCKY, LLC
Practice Location Address:

1410 N RACE ST
GLASGOW, KY
42141-3473

Practice Phone: 270-651-7882
Practice Fax: 270-651-7883

1053640698 — MR. MICHAEL L PENDLETON SR. APRN
Practice Location Address:

1412 N RACE ST
GLASGOW, KY
42141-3473

Practice Phone: 270-629-6333
Practice Fax: 270-629-6334

1972884492 — MARY ANN FORBES SLP
Practice Location Address:

1410 N RACE ST
GLASGOW, KY
42141-3473

Practice Phone: 270-651-7882
Practice Fax:

1417324252 — PENDLETON FAMILY CARE
Practice Location Address:

1412 N RACE ST
GLASGOW, KY
42141-3473

Practice Phone: 270-629-6333
Practice Fax:

1184099103 — KENNY RAY KIMBALL II PT, DPT
Practice Location Address:

1410 N RACE ST
GLASGOW, KY
42141-3473

Practice Phone: 270-651-7882
Practice Fax:

1013433390 — EMILY THOMAS
Practice Location Address:

1410 N RACE ST
GLASGOW, KY
42141-3473

Practice Phone: 270-651-7882
Practice Fax: 270-651-7883

Directions to “ KAYLA BETH SULLIVAN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.