Individual
CONSTANCE R PROSTKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1704 W STOCKTON ST, EDMONTON, KY 42129-8137
(270) 432-4800
(270) 432-4804
Mailing address
1704 W STOCKTON ST, EDMONTON, KY 42129-8137
(270) 432-4800
(270) 432-4804
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3001854
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78018546
—
KY
Enumeration date
01/24/2006
Last updated
03/02/2023
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