Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 3010387 | KY |
NPI | 1003266990 |
---|---|
Provider Name | Alison R Claunch |
First Address | Burkesville, KY 42717-1080 |
Second Address | Columbia, KY 42728-7436 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2016 |
Last Update Date | 17/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3010387 | STATE LICENSE (01) | KY |
7100423510 | (05) | KY |