Individual
MANDY VITTITOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
908 DUPONT RD, LOUISVILLE, KY 40207-4602
(502) 749-7909
(502) 749-9397
Mailing address
100 E LIBERTY ST STE 800, LOUISVILLE, KY 40202-1428
(502) 749-7909
(502) 749-9397
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3011916
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100521430
—
KY
Enumeration date
12/18/2017
Last updated
10/19/2018
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