Organization
PEDIATRIC PARTNERS OF NORTHERN KENTUCKY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA SPRAGUE (OFFICE MANAGER)
(859) 331-4005
Entity
Organization
Contact information
Practice address
1945 HIGHLAND PIKE, SUITE 1, FT WRIGHT, KY 41017-8127
(859) 331-4005
Mailing address
1945 HIGHLAND PIKE, SUITE 1, FT WRIGHT, KY 41017-8127
(859) 331-4005
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65943961
—
KY
Enumeration date
12/12/2006
Last updated
02/07/2023
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