Individual
BRITTA ZOELLER MACIUBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 S 5TH ST, BARDSTOWN, KY 40004-1142
(502) 348-5968
Mailing address
201 S 5TH ST, BARDSTOWN, KY 40004-1142
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
48284
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48284
KBML
KY
Enumeration date
04/20/2012
Last updated
07/25/2015
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