Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 3002887 | KY |
NPI | 1033449202 |
---|---|
Provider Name | Dr. Ruth Robinson Staten |
First Address | Lexington, KY 40536-0001 |
Second Address | Louisville, KY 40205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2010 |
Last Update Date | 29/08/2018 |