| NPI | 1518121581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATISHA L FRAZIER A RN P/Manager 502-554-5851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 4353P) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2008-07-17 |