Provider Demographics
NPI:1285241315
Name:EMBRY, NETTIE P (RN)
Entity type:Individual
Prefix:MS
First Name:NETTIE
Middle Name:P
Last Name:EMBRY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 OLD WAITSBORO RD
Mailing Address - Street 2:
Mailing Address - City:BRONSTON
Mailing Address - State:KY
Mailing Address - Zip Code:42518-8557
Mailing Address - Country:US
Mailing Address - Phone:270-779-0239
Mailing Address - Fax:
Practice Address - Street 1:607 CLIFTY ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-1765
Practice Address - Country:US
Practice Address - Phone:877-794-3812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1097279163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse