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Individual

MS. SALLY R. MCENROE

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
101 HARDIN LN, SOMERSET, KY 42503-3814
(606) 679-7348
(606) 679-4097
Mailing address
510 LEAF LN, SOMERSET, KY 42503-4662
(606) 679-4997
(606) 679-5976

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
235P
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
78001484
KY
Enumeration date
11/04/2005
Last updated
07/08/2007
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