| NPI | 1730473745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY UNDERWOOD Credentialing 859-303-8746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health (Licence: KY 900242) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 363LF0000X Nurse Practitioner Family | |
| 363LP0200X Nurse Practitioner Pediatrics | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2021-09-02 |