| NPI | 1689971970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY E WARREN Owner 606-546-2511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 02875) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 1119255) |
| 363L00000X Nurse Practitioner (Licence: KY 3008480) | |
| Enumeration Date | 2011-02-22 |
| Last Update Date | 2016-10-25 |