Provider Demographics
NPI:1831842152
Name:YANCEY, KENNY RAY (APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:KENNY
Middle Name:RAY
Last Name:YANCEY
Suffix:
Gender:M
Credentials:APRN, PMHNP-BC
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 68
Mailing Address - Street 2:
Mailing Address - City:STEARNS
Mailing Address - State:KY
Mailing Address - Zip Code:42647-0068
Mailing Address - Country:US
Mailing Address - Phone:606-376-9700
Mailing Address - Fax:
Practice Address - Street 1:2157 S HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:STEARNS
Practice Address - State:KY
Practice Address - Zip Code:42647-6297
Practice Address - Country:US
Practice Address - Phone:606-376-9700
Practice Address - Fax:606-376-9703
Is Sole Proprietor?:No
Enumeration Date:2022-01-27
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017108363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily