Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 4276P | KY |
NPI | 1043496813 |
---|---|
Provider Name | Amy M Pendleton |
First Address | Irvine, KY 40336-0115 |
Second Address | Irvine, KY 40336-0115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2008 |
Last Update Date | 11/01/2008 |