Individual
PAVANI NATHALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 HELMWOOD PLAZA DR, ELIZABETHTOWN, KY 42701-2975
(270) 769-5579
(270) 706-5547
Mailing address
100 HELMWOOD PLAZA DR, ELIZABETHTOWN, KY 42701-2975
(502) 769-5579
(270) 706-5547
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
59684
KY
Other
Enumeration date
03/29/2021
Last updated
06/24/2024
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