Headspeth, Chanty Lynn

Headspeth, Chanty Lynn is an individual health care provider with primary practice located at 906 Woodland Dr Ste 102, Elizabethtown KY 42701-2752. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Headspeth, Chanty Lynn can be contacted via phone (270) 765-5127.

Contact Information

Primary practice address
906 Woodland Dr Ste 102 Elizabethtown KY 42701-2752
Phone: (270) 765-5127
Fax: (270) 765-2653
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA541 Kentucky

Profile Details

NPI number 1447250584
LBN Legal business name Headspeth, Chanty Lynn
Credentials PA C
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Feb 9th, 2009 - about 17 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 1447250584 NPPES
Kentucky MEDICAID 9500308300

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