Individual
MRS. RAE ELLEN VIRGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2201 LEXINGTON AVE, ASHLAND, KY 41101-2843
(606) 408-4000
(606) 408-6825
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 408-6200
(606) 408-6612
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3005224
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102779
KY BOARD OF NURSING RN
KY
01
—
2007003977
KY BOARD OF NURSING ARNP
KY
Enumeration date
10/29/2007
Last updated
07/21/2022
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