Provider Demographics
NPI:1427806801
Name:TUTOR, ANNEMARIE (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:ANNEMARIE
Middle Name:
Last Name:TUTOR
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 LARRY SMITH RD
Mailing Address - Street 2:
Mailing Address - City:SMITHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:42081-0019
Mailing Address - Country:US
Mailing Address - Phone:270-350-2674
Mailing Address - Fax:
Practice Address - Street 1:2501 KENTUCKY AVE
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-3813
Practice Address - Country:US
Practice Address - Phone:270-575-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1126093163WM0705X
KY4023159363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical