Organization
WISDOM KEY BEHAVIORAL HEALTH SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY WILLIAMS PMHNP-BC (MANAGER)
(270) 900-0094
Entity
Organization
Contact information
Practice address
1239 WOODLAND DR, SUITE 110, ELIZABETHTOWN, KY 42701-2770
(270) 900-0094
(270) 900-0430
Mailing address
56 DAWSON RD, RADCLIFF, KY 40160-9755
(270) 900-0094
(270) 900-0430
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3006237
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K085600
MEDICARE PTAN
KY
05
—
PENDING
—
KY
Enumeration date
12/18/2012
Last updated
02/28/2014
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