Organization
SOUTHERN KY MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA CUNDIFF / ROY MSN , CANP (CANP)
(270) 866-4357
Entity
Organization
Contact information
Practice address
72 JOE T PETTY DR, RUSSELL SPRINGS, KY 42718
(270) 866-4357
(270) 858-4957
Mailing address
72 JOE T PETTY DR, RUSSELL SPRINGS, KY 42718
(270) 866-4357
(270) 858-4957
Taxonomy
Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
2287P
KY
Other
Enumeration date
12/31/2009
Last updated
12/31/2009
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