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Individual

MARK ANDREW TIGNOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
3920 DUTCHMANS LN, LOUISVILLE, KY 40207-4702
(502) 583-3687
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3007487
KY
363LF0000X
Family Nurse Practitioner
28194658A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3007487
MEDICAL LICENSE
KY
Enumeration date
06/29/2012
Last updated
08/09/2024
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