Provider Demographics
NPI:1700214210
Name:SCEARSE, KRISTY (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:
Last Name:SCEARSE
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 246
Mailing Address - Street 2:
Mailing Address - City:BLEDSOE
Mailing Address - State:KY
Mailing Address - Zip Code:40810
Mailing Address - Country:US
Mailing Address - Phone:606-273-0670
Mailing Address - Fax:606-545-5572
Practice Address - Street 1:80 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:BARBOURVILLE
Practice Address - State:KY
Practice Address - Zip Code:40906-7262
Practice Address - Country:US
Practice Address - Phone:606-546-4175
Practice Address - Fax:606-545-5572
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-18
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008295363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner