Nan Lewis Pack, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA712 Issued in KY

Practice address

1911 Campbellsville Rd
Greensburg, KY 42743-7758

Phone

(270) 932-2221

Fax

(270) 932-2201

NPI assigned

Sep 7, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189123200000",
    "number": "1144415662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 CAMPBELLSVILLE RD",
            "city": "GREENSBURG",
            "state": "KY",
            "postal_code": "427437758",
            "telephone_number": "270-932-2221",
            "fax_number": "270-932-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 CAMPBELLSVILLE RD",
            "city": "GREENSBURG",
            "state": "KY",
            "postal_code": "427437758",
            "telephone_number": "270-932-2221",
            "fax_number": "270-932-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "NAN",
        "middle_name": "LEWIS",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-07",
        "last_updated": "2007-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodney Taylor Moore
• Brittany Lashae Morgan Judd, LMT
• Dana N Neat, LPCC
• Macey Neville
• Jessica L Noble
• Gary L Partin, M.D.
• Karen Partin, APRN
• Anna Grace Patterson, PA-S
• Robert Payne, PHARMD
• Peggy Gwen Pennington

• Medical Physician Assistant in Greensburg, KY
• Providers in Greensburg, KY by specialty
• Medical Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.