MEDICARE: TRISTATE BANP, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1720648850
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRISTATE BANP, LLC

Provider Business Mailing Address
First Line	:	PO BOX 131
Second Line	:
City	:	UNION
State	:	KY
Zip	:	41091-0131
Country	:	US
Telephone Number	:	859-640-3627
Fax Number	:

Provider Business Practice Location Address
First Line	:	5032 LOCH DR
Second Line	:
City	:	UNION
State	:	KY
Zip	:	41091-1485
Country	:	US
Telephone Number	:	859-640-3627
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. LISA AREHART
Credential	:	APRN
Telephone Number	:	859-640-3627

Provider Enumeration Date	:	06/20/2019
Last Update Date	:	07/24/2024

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Directions to “TRISTATE BANP, LLC ” Practice Location

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