Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 3006997 | KY |
NPI | 1013151711 |
---|---|
Provider Name | Ms. Judy Ann Harrison |
First Address | Lexington, KY 40508-1113 |
Second Address | Lexington, KY 40509-4120 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2009 |
Last Update Date | 07/04/2016 |