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Individual

GEORGIA ANN NILES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
850 BARRET AVE, SUITE #301, LOUISVILLE, KY 40204-1745
(502) 574-6699
(502) 574-5922
Mailing address
850 BARRET AVE, SUITE #301, LOUISVILLE, KY 40204-1745
(502) 574-6699
(502) 574-5922

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
4328P
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
78013091
KY
Enumeration date
07/28/2009
Last updated
07/28/2009
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