Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 3011998 | KY |
NPI | 1063913986 |
---|---|
Provider Name | Tara Lynn Denton |
First Address | Louisville, KY 40211-1969 |
Second Address | Louisville, KY 40203-2059 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2018 |
Last Update Date | 08/09/2020 |