| NPI | 1871266676 |
|---|---|
| Former Name | NICHOLAS AUSTEN BLAKE BISCHOFF-NUNLEY |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3016559) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1165642) |
| Enumeration Date | 2021-07-28 |
| Last Update Date | 2022-02-08 |