Provider Demographics
NPI:1811964091
Name:CAIN, NOYE ROWGENA (APRN)
Entity type:Individual
Prefix:
First Name:NOYE
Middle Name:ROWGENA
Last Name:CAIN
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 1:910 WALLACE AVE
Mailing Address - Street 2:
Mailing Address - City:LEITCHFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42754-2414
Mailing Address - Country:US
Mailing Address - Phone:270-259-2714
Mailing Address - Fax:270-259-3593
Practice Address - Street 1:910 WALLACE AVE
Practice Address - Street 2:
Practice Address - City:LEITCHFIELD
Practice Address - State:KY
Practice Address - Zip Code:42754-2414
Practice Address - Country:US
Practice Address - Phone:270-259-2714
Practice Address - Fax:270-259-3593
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4687P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY2683221000OtherPASSPORT ADVANTAGE
KY000000390266OtherANTHEM
KY50009633OtherPASSPORT
KY78016102Medicaid
KY2683221000OtherPASSPORT ADVANTAGE
KY78016102Medicaid