Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 3012875 | KY |
NPI | 1184272916 |
---|---|
Provider Name | Tracy Hayden Schamel |
First Address | Louisville, KY 40202-1675 |
Second Address | Louisville, KY 40202-1675 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2019 |
Last Update Date | 26/08/2019 |