Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 3015114 | KY |
NPI | 1033725353 |
---|---|
Provider Name | Cheryl Elder |
First Address | Owensboro, KY 42301-2956 |
Second Address | Owensboro, KY 42301-2956 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2020 |
Last Update Date | 22/09/2020 |