Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 37833 | KY |
NPI | 1003831652 |
---|---|
Provider Name | Dr. Susan Kathleen Mueller |
First Address | Paducah, KY 42003-3817 |
Second Address | Paducah, KY 42003-3817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 12/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64060288 | (05) | KY |
H77617 | (02) | KY |