Provider Demographics
NPI:1720050628
Name:PIKE, NANCY E (ARNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:E
Last Name:PIKE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:HEAVRIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:181 LEES VALLEY ROAD
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-0278
Mailing Address - Country:US
Mailing Address - Phone:502-955-7837
Mailing Address - Fax:502-543-2998
Practice Address - Street 1:181 LEES VALLEY ROAD
Practice Address - Street 2:
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-0278
Practice Address - Country:US
Practice Address - Phone:502-955-7837
Practice Address - Fax:502-543-2998
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY214P363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0223504OtherMEDICARE GROUP
KY0223504OtherMEDICARE GROUP