Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 3007422 | KY |
N | 363LW0102X | Nurse Practitioner - Women's Health | COA.12405-NP | OH |
NPI | 1003212952 |
---|---|
Provider Name | Alicia Krummen |
First Address | Florence, KY 41042-1513 |
Second Address | Florence, KY 41042-1513 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2014 |
Last Update Date | 13/09/2018 |