Individual
REX DEWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
550 S JACKSON ST, LOUISVILLE, KY 40202-1622
(502) 562-3120
(502) 588-4427
Mailing address
401 E CHESTNUT ST UNIT 600, LOUISVILLE, KY 40202-5705
(502) 588-4425
(502) 588-4427
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3013925
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3013925
APRN PSYCHIATRY BOARD
KY
Enumeration date
10/07/2019
Last updated
10/07/2019
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