# MERCY FAMILY MEDICINE AND WELLNESS CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518613579
- **Authorized official:** SHELLEY ROBY APRN (OWNER/APRN)
- **Authorized official phone:** (270) 304-8184

## Contact information

- **Practice address:** 217 S MULBERRY ST, ELIZABETHTOWN, KY 42701-1430
- **Practice address phone:** (270) 304-8184
- **Practice address fax:** (502) 265-4318
- **Mailing address:** 553 TABB RD, CECILIA, KY 42724-9776
- **Mailing address phone:** (270) 304-8184

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 02/28/2022
- **Last updated:** 12/28/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7100816430 | — | KY |