Standafer, Glen R

Standafer, Glen R is an individual health care provider with primary practice located at 732 Highway 36 , Frenchburg KY 40322-8123. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Standafer, Glen R can be contacted via phone (606) 768-2191.

Contact Information

Primary practice address
732 Highway 36 Frenchburg KY 40322-8123
Phone: (606) 768-2191
Fax: (606) 768-6130
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 3007175 Kentucky

Profile Details

NPI number 1669759064
LBN Legal business name Standafer, Glen R
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2011
Last updated Sep 22nd, 2015 - about 9 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 1669759064 NPPES
Kentucky MEDICAID 7100192030

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