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Contact Information

VANDERBILT INTEGRATED PROVIDERS
1717 HIGH STREET
SUITE 3A
HOPKINSVILLE, KY42240
 Phone: 270-885-8445
 Fax: 270-886-9106
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

363LP0200X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for VANDERBILT INTEGRATED PROVIDERS · (Female)

NPI Number 1255463949
Status Active
Credentials
Entity Individual
Enumeration date 03/09/2007
Last updated 02/27/2013 - About 13 years ago
Sole proprietor 1 Not specified
Identifiers
  • KY License # 3002428
  • KY License # 3004549
  • KY Medicaid 78900800
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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