# CARRICO CONGLETON FAMILY PRACTICE, LLC

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

## Provider details

- **NPI number:** 1750665162
- **Authorized official:** JUDY A CARRICO APRN (OWNER)
- **Authorized official phone:** (270) 215-0234

## Contact information

- **Practice address:** 2811 NEW HARTFORD ROAD, SUITE B, OWENSBORO, KY 42303-1320
- **Practice address phone:** (270) 215-0234
- **Practice address fax:** (270) 215-0316
- **Mailing address:** 2811 NEW HARTFORD RD STE B, OWENSBORO, KY 42303-1384
- **Mailing address phone:** (270) 215-0234
- **Mailing address fax:** (270) 215-0316

## Taxonomy

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

## Other

- **Enumeration date:** 10/04/2011
- **Last updated:** 02/21/2019