Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 3016431 | KY |
NPI | 1013681428 |
---|---|
Provider Name | Alexandria Dulay |
First Address | Richmond, KY 40475-1408 |
Second Address | Lexington, KY 40513-1302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2021 |
Last Update Date | 14/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MD6709262 | DEA (01) | KY |