Individual
MAE DINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7766 EWING BLVD, STE 100, FLORENCE, KY 41042-7537
(859) 283-1033
(859) 283-1066
Mailing address
7766 EWING BLVD, STE 100, FLORENCE, KY 41042-7537
(859) 283-1033
(859) 283-1066
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1830
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA1830
KENTUCKY BOARD OF MEDICAL LICENSURE
KY
Enumeration date
01/02/2014
Last updated
01/02/2014
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