| NPI | 1538952320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF BEATY VP 502-381-9053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2025-05-26 |
| Last Update Date | 2025-05-26 |