| NPI | 1992254288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY D MCCARY Office Manager 270-251-4040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010022) |
| Enumeration Date | 2016-09-27 |
| Last Update Date | 2016-09-27 |