Mary Lauretta Branstetter, APRN
Individual provider Active NPI Family Nurse Practitioner · Glasgow, KY
NPI 1902875644 · NPPES record last updated May 15, 2014
Key facts
- NPI
- 1902875644
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 3002615 (KY)
- Practice address
- 301 Professional Park Dr
Glasgow, KY 42141-3487 - Phone
- (270) 651-9696
- Fax
- (270) 651-0385
- NPI assigned
- Mar 15, 2006
- Sex
- Female
- Sole proprietor
- No
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3002615 | KY | Yes |
Addresses
Primary practice location
301 Professional Park Dr
Glasgow, KY 42141-3487
Mailing address
PO Box 1080
Burkesville, KY 42717-1080
Phone (270) 864-1472
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 78004363 | Medicaid | KY |
Other providers in Glasgow, KY
- Roger Kenton Bowman
- Olivia Marie Bradshaw
- William J Bradshaw
- Rachel Branham
- Gregory Branstetter
- Regina Branum
- Leticia Bravo
- Orlando Bravo
- Amy Brickler
- Brightview LLC
All providers in Glasgow, KY · Family 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 May 15, 2014. 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.