Provider Demographics
NPI:1770686818
Name:WITTEN, NANCY DARLENE (ARNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:DARLENE
Last Name:WITTEN
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 1:1201 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2709
Mailing Address - Country:US
Mailing Address - Phone:270-737-2727
Mailing Address - Fax:270-737-7977
Practice Address - Street 1:1201 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2709
Practice Address - Country:US
Practice Address - Phone:270-737-2727
Practice Address - Fax:270-737-7977
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY504P363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78003530Medicaid
585805Medicare UPIN
KY0263007Medicare ID - Type Unspecified