Organization
BARDSTOWN PRIMARY CARE, PLLC
Active
Organization
BARDSTOWN PRIMARY CARE, PLLC
Active
Other names
PHYSICIANS TO CHILDREN & ADOLESCENTS
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY JO NALLEY (ADMINISTRATOR)
(502) 348-7554
Entity
Organization
Contact information
Practice address
201 S 5TH ST, BARDSTOWN, KY 40004-1142
(502) 348-7554
(502) 337-6070
Mailing address
201 S 5TH ST, BARDSTOWN, KY 40004-1142
(502) 350-0050
(502) 348-6505
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
09/09/2005
Last updated
10/29/2019
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