| NPI | 1841891645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN TIERNEY LANHAM Owner 502-552-8597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2022-04-12 |