Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | 3015561 | KY |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 3015561 | KY |
NPI | 1457941668 |
---|---|
Provider Name | Letrisha Nowlin |
First Address | Louisville, KY 40291-5142 |
Second Address | Louisville, KY 40291-5142 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2021 |
Last Update Date | 17/05/2021 |