Vickie Robertson, RN

Individual provider Active NPI Registered Nurse · Jamestown, KY

NPI 1023400124 · NPPES record last updated Feb 26, 2015

Key facts

NPI
1023400124
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
1048211 (KY)
Practice address
119 Herriford Curve Rd
Jamestown, KY 42629
Phone
(270) 343-2551
NPI assigned
Feb 26, 2015
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
1048211KYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Cumberland Regional MHMR Board Outpatient Past Accepting new patients
Lake Cumberland Regional Mental Health Mental Retardation Board, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1048211 KY Yes

Addresses

Primary practice location

119 Herriford Curve Rd
Jamestown, KY 42629

Mailing address

130 Southern School Rd
Somerset, KY 42501-3223

Other providers in Jamestown, KY

All providers in Jamestown, KY · Registered Nurse in Kentucky

Sources for this page

Verify at the official NPI Registry.