Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 3015855 | KY |
N | 363LA2200X | Nurse Practitioner - Adult Health | 3015855 | KY |
N | 363LG0600X | Nurse Practitioner - Gerontology | 3015855 | KY |
Y | 363LP2300X | Nurse Practitioner - Primary Care | 3015855 | KY |
NPI | 1013684968 |
---|---|
Provider Name | Dr. Kenneth Ngocha Morfaw |
First Address | Nicholasville, KY 40356-8235 |
Second Address | Nicholasville, KY 40356-8235 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2021 |
Last Update Date | 27/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000 | NONE (01) |