Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Icc Medical LLC

Organization Family Nurse Practitioner · NPI 1376730705

Icc Medical LLC provides Family Nurse Practitioner services in Glasgow, Kentucky. Licensed in Kentucky. Registered with an NPI since 2007.

Licensed in
KY
In the registry since
2007
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

405 S L Rogers Wells Blvd
Glasgow, KY 42141-1725 Not confirmed with CMS for 19 years — call before visiting
Phone: (270) 834-8892
Fax: (270) 834-8899
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 4074P (KY)

Record details

NPI number1376730705
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Roger Williams — Owner · (270) 834-8892
NPI enumeratedOctober 1, 2007
Last updated in NPPESOctober 1, 2007
Mailing address405 S L Rogers Wells Blvd, Glasgow, KY 42141-1725

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