| NPI | 1013468784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE WHITING Credentialing Coordinator 859-539-2466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007742) |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2016-10-19 |