Provider Demographics
NPI:1124385257
Name:O'ROURKE, ARDITH ELAINE (MSN, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:ARDITH
Middle Name:ELAINE
Last Name:O'ROURKE
Suffix:
Gender:F
Credentials:MSN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 J.E.ELLIS ROAD
Mailing Address - Street 2:WARRIOR COAL, LLC
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431
Mailing Address - Country:US
Mailing Address - Phone:270-249-6041
Mailing Address - Fax:270-249-3204
Practice Address - Street 1:57 J.E. ELLIS ROAD
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431
Practice Address - Country:US
Practice Address - Phone:270-249-6041
Practice Address - Fax:270-249-3204
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-13
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007408363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily