Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 3010490 | KY |
NPI | 1144673161 |
---|---|
Provider Name | Emily Hahn Pinkham |
First Address | Louisville, KY 40201-0909 |
Second Address | Louisville, KY 40202-1821 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2016 |
Last Update Date | 12/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7100419110 | (05) | KY |
K207310 | MEDICARE (01) | KY |