Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 02965 | KY |
NPI | 1013992460 |
---|---|
Provider Name | Dr. Amy Preen |
First Address | Elizabethtown, KY 42701-2749 |
Second Address | Elizabethtown, KY 42701-2749 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2005 |
Last Update Date | 13/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1869202 | MEDICARE ID-TYPE UNSPECIFIED (01) | KY |
7100017210 | (05) | KY |
I69435 | (02) | KY |