Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 2068P | KY |
NPI | 1164639381 |
---|---|
Provider Name | Vicki L Herman |
First Address | Hopkinsville, KY 42241-2400 |
Second Address | Hopkinsville, KY 42240-1965 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 25/08/2015 |