Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 3010580 | KY |
NPI | 1003268467 |
---|---|
Provider Name | Anna Kelly Hardin |
First Address | Mc Kee, KY 40447-7089 |
Second Address | Lexington, KY 40536-7356 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2016 |
Last Update Date | 27/02/2019 |