Nicole K Demetriou, CNM FNP
Individual provider Active NPI Nurse Practitioner · Hyden, KY
NPI 1770540817 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1770540817
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 4779P (KY)
- Practice address
- 130 Kate Ireland Dr
Hyden, KY 41749 - Phone
- (606) 672-2901
- Fax
- (606) 672-3626
- NPI assigned
- May 1, 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
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4779P | KY | MD | Nurse Practitioner |
| 4779M | KY | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frontier Nursing Healthcare | Past | Accepting new patients | |
| Take Care Health Services PA | Nurse Practitioner | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4779P | KY | Yes |
| Advanced Practice Midwife | 367A00000X | 4779M | KY |
Addresses
Primary practice location
130 Kate Ireland Dr
Hyden, KY 41749
Mailing address
130 Kate Ireland Dr
Hyden, KY 41749
Phone (606) 672-2901
Other providers in Hyden, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. 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.