Kathy Dianne Phelps, APRN FNP
Individual provider Active NPI Nurse Practitioner · Paducah, KY
NPI 1699863514 · NPPES record last updated Dec 7, 2012
Key facts
- NPI
- 1699863514
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 3143P (KY)
- Practice address
- 3131 Parisa Dr
Paducah, KY 42003-4584 - Phone
- (270) 444-8000
- Fax
- (270) 444-8302
- NPI assigned
- Oct 10, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3143P | KY | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Purchase Care LLC | Past | Accepting new patients | |
| Comprehensive Premier Medicine, PLLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 3143P | KY | Yes |
Addresses
Primary practice location
3131 Parisa Dr
Paducah, KY 42003-4584
Mailing address
PO Box 1175
Calvert City, KY 42029
Phone (270) 395-5388
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 78015690 | Medicaid | KY | |
| 000000340382 | Other | ANTHEM |
Other providers in Paducah, KY
- Ashley Peterson
- John Paul Hobbs Peterson
- Samuel Peterson
- Pharmacy, Inc.
- Catryna Michele Phelps
- Philip G Hunt M D Orthopedics P S C
- Christopher Raymond Phillips
- Russell Glenn Phillips
- Vicki Phillips
- Rachel Mae Pickett
All providers in Paducah, KY · Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.