NPI | 1265205553 |
---|---|
Entity Type | Organization |
Authorized Contact | CARA NETHERTON Credentialing Agent 859-248-6415 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 251S00000X |
363L00000X Nurse Practitioner | |
Enumeration Date | 2023-10-30 |
Last Update Date | 2024-11-19 |