Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 3007714 | KY |
NPI | 1578816864 |
---|---|
Provider Name | Danielle Smith |
First Address | Nicholasville, KY 40356-6038 |
Second Address | Middletown, KY 40243-1538 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2012 |
Last Update Date | 24/10/2012 |