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:
Health care specialties
Specialty | Code | License # | 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 last year |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1053502260 | NPPES |
Kentucky | MEDICAID | 7100072050 |
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