| NPI | 1194704866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE A OSBORNE Credentialing Manager 502-634-6767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363AS0400X Physician Assistant, Surgical | |
| 363L00000X Nurse Practitioner | |
| 363LA2100X Nurse Practitioner, Acute Care | |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine | |
| 207R00000X Internal Medicine | |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner, Family | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2022-07-06 |