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Individual

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Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
130 DANIEL DR, DANVILLE, KY 40422-2527
(859) 236-2222
Mailing address
PO BOX 990, DANVILLE, KY 40423-0990
(859) 239-2468
(859) 239-6785

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
3016801
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100807700
KY
Enumeration date
10/31/2021
Last updated
08/15/2023
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