| NPI | 1447469580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM ANNETTE SICKELS Nurse Practitioner 502-939-9754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71000724A) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 4488P) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2007-12-05 |