Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 333P | KY |
NPI | 1033102595 |
---|---|
Provider Name | Mrs. Margaret Boyle Friel |
First Address | Lawrenceburg, KY 40342-9252 |
Second Address | Lawrenceburg, KY 40342-9252 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
78000015 | (05) | KY |
R36879 | (02) |