Individual
REAGAN POE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1903 BROADWAY ST STE B, PADUCAH, KY 42001-7105
(270) 444-8183
(270) 444-8147
Mailing address
239 MT PARKWAY SPUR, CAMPTON, KY 41301
(606) 668-6932
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000388604
ANTHEM BC/BS
KY
05
—
95005468
—
KY
Enumeration date
06/26/2006
Last updated
03/21/2024
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