Individual
TARAH D WAFZIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-NP
Contact information
Practice address
187 ADAM SHEPHERD PKWY STE 5, SHEPHERDSVILLE, KY 40165-7500
(502) 543-4119
(502) 543-1462
Mailing address
100 E LIBERTY ST, SUITE 800, LOUISVILLE, KY 40202-1434
(502) 543-4119
(502) 543-1462
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3008895
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100365350
—
KY
Enumeration date
09/19/2014
Last updated
03/21/2018
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