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Individual

SALLY WADDLE MCGEEHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
9800 SHELBYVILLE RD, SUITE #220, LOUISVILLE, KY 40223-2977
(502) 429-8585
(502) 753-0889
Mailing address
206 E OAK ST, SOMERSET, KY 42501-1421
(606) 678-0783

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
298P
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1881785947
GROUP NPI
KY
05
78001013
KY
Enumeration date
07/26/2005
Last updated
06/03/2010
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