Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 3787P | KY |
NPI | 1174525158 |
---|---|
Provider Name | Susan Hoff-Thomas |
First Address | Lexington, KY 40503-1475 |
Second Address | Lexington, KY 40503-1475 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q35505 | (02) | KY |