| NPI | 1992011050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN LEIGH MILLER General Counsel 502-327-9100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2018-03-17 |