Individual
HEATHER J MUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
444 S 1ST ST, SUITE 100, LOUISVILLE, KY 40202-1416
(502) 583-6647
Mailing address
PO BOX 36422, LOUISVILLE, KY 40233-6422
(502) 583-6647
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
4440P
KY
363L00000X
Nurse Practitioner
Primary
40176
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78013695
—
KY
01
—
P00343544
RR MCR
KY
Enumeration date
05/09/2006
Last updated
11/28/2007
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