Individual
JO A SPATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2650 W BROADWAY, LOUISVILLE, KY 40211-1333
(502) 589-8600
(502) 589-8771
Mailing address
101 W MUHAMMAD ALI BLVD, LOUISVILLE, KY 40202-1423
(502) 589-8600
(502) 589-8771
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3003275
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100143380
—
KY
Enumeration date
08/20/2006
Last updated
03/06/2015
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