Individual
BETH ELLEN KILLIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
475 SHOPPERS DR, WINCHESTER, KY 40391-1380
(859) 744-5111
(859) 744-1177
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7818
(606) 330-7825
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3003665
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6400
GROUP MEDICARE #
KY
05
—
78008265
—
KY
05
—
78901261
—
KY
Enumeration date
04/19/2006
Last updated
08/06/2019
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