| NPI | 1336932144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF BEATY Member Vice President 502-381-9053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2025-05-24 |
| Last Update Date | 2025-05-24 |