| NPI | 1487168936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON DUNN Member 270-741-3044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3010523) |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2018-03-23 |