Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 3008353 | KY |
NPI | 1003243858 |
---|---|
Provider Name | Ashley Brooke Munn |
First Address | Manchester, KY 40962-6195 |
Second Address | Manchester, KY 40962-6212 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2013 |
Last Update Date | 10/10/2013 |