| NPI | 1417567918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SETH J SUMMERS Vice President 502-523-7547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology |
| Enumeration Date | 2020-08-09 |
| Last Update Date | 2020-10-01 |