Organization
BOURBON PHYSICIAN PRACTICE LLC
Active
Other names
Carlisle Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA BOWMAN (PRESIDENT)
(615) 920-7000
Entity
Organization
Contact information
Practice address
107 S BROADWAY ST, CARLISLE, KY 40311-1150
(859) 289-4124
(859) 289-4126
Mailing address
107 S BROADWAY ST, CARLISLE, KY 40311-1150
(859) 289-4124
(859) 289-4126
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
KY
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
01/30/2013
Last updated
09/24/2022
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