| NPI | 1336514264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE BEYKE Manager 270-691-1834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3009832) |
| Enumeration Date | 2015-12-03 |
| Last Update Date | 2015-12-03 |