Individual
MRS. REISHA L CAUDILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1340 S LAUREL RD, LONDON, KY 40744-8304
(859) 813-4109
Mailing address
1340 S LAUREL RD, LONDON, KY 40744-8304
(859) 813-4109
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
3008255
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3008255
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20-2056353
—
KY
Enumeration date
08/26/2013
Last updated
09/23/2020
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