SAMUEL ADDISON GULLEY PA-S
NPI 1114718905
Student in an Organized Health Care Education/Training Program in Fort Campbell, KY
- Individual
- Male
- Student in an Organized Health Care Educ...
About SAMUEL GULLEY
This page provides the complete NPI Profile along with additional information for Samuel Gulley, a primary care provider established in Fort Campbell, Kentucky with a medical specialization in Student In An Organized Health Care Education/training Program. The healthcare provider is registered in the NPI registry with number 1114718905 assigned on May 2025. The practitioner's primary taxonomy code is 390200000X. The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1114718905 Verify this NPI
- Provider Name
- SAMUEL ADDISON GULLEY PA-S
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 650 JOEL DR FORT CAMPBELL, KY 42223
- Location Phone
- (270) 956-0336
- Mailing Address
- 650 JOEL DR FORT CAMPBELL, KY 42223
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-13-2025
- Last Update Date
- 05-13-2025
- Code Navigator
A primary care provider (PCP) like Samuel Gulley sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Student in an Organized Health Care Education/Training Program
- Taxonomy Code
- 390200000X
- Type
- Student, Health Care
- Taxonomy Description
- An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 171000000X | Other Service Providers | Military Health Care Provider | |
| 2 | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
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Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
FORT CAMPBELL, KY 42223
FORT CAMPBELL, KY 42223
FORT CAMPBELL, KY 42223
FORT CAMPBELL, KY 42223
FORT CAMPBELL, KY 42223
FT. CAMPBELL, KY 42223
FORT CAMPBELL, KY 42223
FORT CAMPBELL, KY 42223
FT. CAMPBELL, KY 42223
FT. CAMPBELL, KY 42223
FORT CAMPBELL, KY 42223
FORT CAMPBELL, KY 42223
FORT CAMPBELL, KY 42223
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1114718905, enumerated as an "individual" on May 13, 2025.
The provider is located at 650 JOEL DR FORT CAMPBELL, KY 42223 and the phone number is (270) 956-0336.
Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
