Bardstown Primary Care, Pllc

NPI 1053305524 - Nurse Practitioner - 363L00000X

NPI Details
NPI 1053305524
Enumeration Date 09/09/2005
Last Updated 09/06/2013
Entity Type Healthcare Provider
Active Over 12 years ago
Authorized Information
Name MARY JO MARY JO
Position ADMINISTRATOR
Phone (502) 350-0050
Fax (502) 348-6505
Practice Location
201 S 5TH ST
BARDSTOWN KY, 40004-1142, US
Phone (502) 350-0050
Fax (502) 348-6505
Business Location
201 S 5TH ST
BARDSTOWN KY, 40004-1142, US
Phone (502) 350-0050
Fax (502) 348-6505
Toxanomy
Taxonomy Code 363L00000X
License State
License Number
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According to our database, Bardstown Primary Care, Pllc NPI is 1053305524, taxonomy code is 363L00000X Bardstown Primary Care, Pllc physically located at 201 S 5th St, Bardstown KY, 40004-1142. NPI Number 1033115704 has the healthcare provider type.

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1053305524 NPI number is provided on an as is basis without warranty of any kind. 1053305524 is maintained by the National Plan & Provider Enumeration System. The contents of Bardstown Primary Care, Pllc are for informational purposes only.