Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 50427 | KY |
NPI | 1003218470 |
---|---|
Provider Name | Ashley Minton |
First Address | Ft. Mitchell, KY 41017-1673 |
Second Address | Alexandria, KY 41001-2107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2014 |
Last Update Date | 21/06/2017 |