Provider Demographics
NPI:1518966936
Name:FURNISH, THERESA (ARNP)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:FURNISH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 THOMAS MORE PKWY
Mailing Address - Street 2:STE. 260
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-5100
Mailing Address - Country:US
Mailing Address - Phone:859-957-0700
Mailing Address - Fax:859-957-0703
Practice Address - Street 1:340 THOMAS MORE PKWY
Practice Address - Street 2:STE. 260
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-5100
Practice Address - Country:US
Practice Address - Phone:859-957-0700
Practice Address - Fax:859-957-0703
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3002531363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYNP531POtherCHOICE CARE
KY78008752Medicaid
KY000000183292OtherANTHEM
KYS84435Medicare UPIN
KY78008752Medicaid