Provider Demographics
NPI:1497893085
Name:BURCHFIELD, NICHOL B (PA-C)
Entity Type:Individual
Prefix:
First Name:NICHOL
Middle Name:B
Last Name:BURCHFIELD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2122
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-2122
Mailing Address - Country:US
Mailing Address - Phone:606-422-4764
Mailing Address - Fax:606-754-0770
Practice Address - Street 1:17401 KY HIGHWAY 80 E
Practice Address - Street 2:
Practice Address - City:ELKHORN CITY
Practice Address - State:KY
Practice Address - Zip Code:41522-8226
Practice Address - Country:US
Practice Address - Phone:606-754-7100
Practice Address - Fax:606-754-0770
Is Sole Proprietor?:No
Enumeration Date:2007-02-03
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA559363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000637023OtherBCBS
KY1629114707OtherEKAHC GROUP NPI
KYP00048501OtherRAILROAD MEDICARE
KY95000733Medicaid
KY7100146710OtherMEDICAID PRIMARY CARE GROUP NUMBER EKAHC
KY7100146710OtherMEDICAID PRIMARY CARE GROUP NUMBER EKAHC
KYP14094Medicare UPIN