Organization
CHIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MAUPIN APRN (OWNER)
(859) 200-4513
Entity
Organization
Contact information
Practice address
920 RICHMOND RD, IRVINE, KY 40336-7230
(606) 717-0177
Mailing address
920 RICHMOND RD, IRVINE, KY 40336-7230
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
03/24/2023
Last updated
01/19/2024
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