Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 175127 | KY |
N | 222Z00000X | Podiatrist | 175127 | KY |
N | 213E00000X | Podiatrist | CPO03960 | NC |
N | 222Z00000X | Podiatrist | CPO03960 | NC |
N | 224P00000X | Prosthetist | 175127 | KY |
Y | 224P00000X | Prosthetist | CPO03960 | NC |
NPI | 1164035952 |
---|---|
Provider Name | Drew Lewis Nutter |
First Address | Nicholasville, KY 40356-9169 |
Second Address | Monroe, NC 28112-5173 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2020 |
Last Update Date | 11/09/2020 |