| NPI | 1396267704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA BISHOP Ap RN 502-655-9744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3008816) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2022-07-21 |