Clisty Nicole Earlywine, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4042462 Issued in KY

Practice address

2666 Thomas Pike
Mount Olivet, KY 41064-7450

Phone

(606) 748-9001

NPI assigned

Sep 9, 2025

Last updated

Sep 9, 2025By the provider in NPPES

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

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Caremed Health Solutions of Kentucky, LLC

  • Multi-Specialty Clinic/Center
  • Ashland, KY
  • NPI 1326789462
  Medicare reassignment NPD
• Provider Partners Care Management LP

  • Nurse Practitioner
  • Columbia, MD
  • NPI 1013348028

  KY

  Medicare reassignment NPD

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

{
    "created_epoch": "1757376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1255212965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2666 THOMAS PIKE",
            "city": "MOUNT OLIVET",
            "state": "KY",
            "postal_code": "410647450",
            "telephone_number": "606-748-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2666 THOMAS PIKE",
            "city": "MOUNT OLIVET",
            "state": "KY",
            "postal_code": "410647450",
            "telephone_number": "606-748-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARLYWINE",
        "first_name": "CLISTY",
        "middle_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-09",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4042462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Buffalo Trace District Health Department (Robertson Co HD School Clinic)
• Eugonda Fryman, APRN
• Lauren Hughes
• Hunter Alexis Jolly, MSN, APRN, AGACNP-BC
• Kimberly Wells Moore, NP
• Sage Remley, OT

• Nurse Practitioner in Mount Olivet, KY
• Providers in Mount Olivet, KY by specialty
• Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.