Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service |
NPI | 1477715480 |
---|---|
Provider Name | Kourtni Sharee Badgett |
First Address | Lexington, KY 40509-8428 |
Second Address | Lexington, KY 40502-2235 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2008 |
Last Update Date | 30/06/2008 |