Individual
MARYELLEN TUSSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
207 N CAROL MALONE BLVD STE 3, GRAYSON, KY 41143-1566
(606) 225-8200
(888) 606-7354
Mailing address
207 N CAROL MALONE BLVD STE 3, GRAYSON, KY 41143-1566
(606) 225-8200
(888) 606-7354
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3015040
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063026110
—
KY
05
—
7100731360
—
KY
Enumeration date
09/06/2020
Last updated
08/02/2024
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