Mortimer, Beverly Jo

Mortimer, Beverly Jo is an individual health care provider with primary practice located at 1330 N Race St , Glasgow KY 42141-3465. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Mortimer, Beverly Jo can be contacted via phone (270) 629-5111.

Contact Information

Primary practice address
1330 N Race St Glasgow KY 42141-3465
Phone: (270) 629-5111
Fax: (270) 783-3760
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 5266P Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3005266 Kentucky

Profile Details

NPI number 1053502260
LBN Legal business name Mortimer, Beverly Jo
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2007
Last updated Feb 22nd, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053502260 NPPES
Kentucky MEDICAID 7100072050

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