Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 3009019 | KY |
NPI | 1033509393 |
---|---|
Provider Name | Dawn Garrett -Wright |
First Address | Bowling Green, KY 42104-4330 |
Second Address | Bowling Green, KY 42101-3516 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2015 |
Last Update Date | 25/02/2015 |