Individual
SANDRA KAY IRVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
937 CAMPBELLSVILLE RD, COLUMBIA, KY 42728-2265
(270) 384-2777
(270) 384-2770
Mailing address
PO BOX 1080, BURKESVILLE, KY 42717-1080
(270) 864-1472
(270) 864-1693
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3004654
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78015112
—
KY
Enumeration date
01/10/2007
Last updated
08/26/2020
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