| NPI | 1871236950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA MICHELLE MARSHAL Owner 859-539-4653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2022-04-18 |
| Last Update Date | 2023-01-25 |