| NPI | 1912776998 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JACQUELINE SANDERS Credentialing Manager 502-630-2036  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 163WW0000X Registered Nurse, Wound Care | 
| Enumeration Date | 2024-01-01 | 
| Last Update Date | 2024-01-01 |