| NPI | 1164518130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA RAE BARRY Practice Manager 859-277-8560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 174400000X Specialist (Licence: KY 25337) | |
| 174400000X Specialist (Licence: KY 26673) | |
| 364SF0001X Clinical Nurse Specialist, Family Health (Licence: KY 3005655) | |
| 207Q00000X Family Medicine (Licence: KY 41917) | |
| 363LF0000X Nurse Practitioner, Family | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2014-12-18 |