Provider Demographics
NPI:1962469007
Name:COMER, AMY R (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:R
Last Name:COMER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
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Mailing Address - Street 1:210 BEVINS LN
Mailing Address - Street 2:STE C
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-6120
Mailing Address - Country:US
Mailing Address - Phone:502-868-0622
Mailing Address - Fax:502-868-9097
Practice Address - Street 1:210 BEVINS LN
Practice Address - Street 2:STE C
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-6120
Practice Address - Country:US
Practice Address - Phone:502-868-0622
Practice Address - Fax:502-868-9097
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY4667P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78015138Medicaid
KY0905104Medicare ID - Type Unspecified
KYQ52375Medicare UPIN