Provider Demographics
NPI:1508195298
Name:MCCARTY, WENDY KAY (APRN)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:KAY
Last Name:MCCARTY
Suffix:
Gender:F
Credentials:APRN
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 909
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-0909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1707 CEDAR GROVE RD STE 15
Practice Address - Street 2:
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-8572
Practice Address - Country:US
Practice Address - Phone:502-543-3246
Practice Address - Fax:502-543-3251
Is Sole Proprietor?:No
Enumeration Date:2009-12-09
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006249363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200976120Medicaid
KY9769702OtherCIGNA - NRP
KY109926OtherSIHO - NRP
KY000052152TOtherHUMANA - NRP
KY000000641811OtherANTHEM - NRP
KY50026885OtherPASSPORT - NRP
KY7100097760Medicaid
IN200976120Medicaid
KYK081272 (KOHMG)Medicare PIN
KY9769702OtherCIGNA - NRP