| NPI | 1023111929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON FIESSINGER Family Nurse Practitioner 270-527-3900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY KY 3122P) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2012-04-20 |