Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 3013290 | KY |
NPI | 1013572767 |
---|---|
Provider Name | Frances Hines |
First Address | Shelbyville, KY 40065-9358 |
Second Address | Louisville, KY 40241-2861 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2019 |
Last Update Date | 19/10/2020 |