Provider Demographics
NPI:1437886736
Name:PHILPOT, PHEBIA LYNN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:PHEBIA
Middle Name:LYNN
Last Name:PHILPOT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:PHEBIA
Other - Middle Name:LYNN
Other - Last Name:CARNAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:520 TECHWOOD DR N STE 100
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-8500
Mailing Address - Country:US
Mailing Address - Phone:859-936-9844
Mailing Address - Fax:859-236-0320
Practice Address - Street 1:1708 FOREST DR
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-2327
Practice Address - Country:US
Practice Address - Phone:606-528-5000
Practice Address - Fax:606-528-5113
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-05
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017965363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100841100Medicaid