| NPI | 1518417179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA TAYLOR Owner 502-825-0075 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2016-10-07 |
| Last Update Date | 2018-12-14 |