Individual
MARY RUTH CARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2605 KENTUCKY AVE, SUITE 301, PADUCAH, KY 42003-3800
(270) 443-1220
(270) 443-0023
Mailing address
2605 KENTUCKY AVE, SUITE 306, PADUCAH, KY 42003-3800
(270) 415-7653
(270) 575-8359
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
3002203
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100096180
—
KY
Enumeration date
04/10/2007
Last updated
08/18/2016
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