NPI | 1972731032 |
---|---|
Entity Type | Organization |
Authorized Contact | JACQUE DESHAY YOUNG Nurse Practitioner 502-644-4068 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 5867P) |
Enumeration Date | 2009-06-29 |
Last Update Date | 2009-09-09 |