| NPI | 1871827527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS BERNARD SHIELDS Owner 270-776-3381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 6167) |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2009-09-29 |