| NPI | 1275582074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER A MARTIN President 270-683-3073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: KY 40335) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 012840) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3006106) | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2024-05-21 |