| NPI | 1518321769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOY L STEVENS VP Of Revenue Assurance 502-244-2441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: KS 12-00421) |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2025-10-30 |