Healthcare Provider Details

I. General information

NPI: 1609189216
Provider Name (Legal Business Name): UNYIME EDET EYOH RN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2010
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 S 4TH ST STE 700
LOUISVILLE KY
40202-3046
US

IV. Provider business mailing address

312 S 4TH ST STE 700
LOUISVILLE KY
40202-3046
US

V. Phone/Fax

Practice location:
  • Phone: 502-804-5495
  • Fax: 833-563-1715
Mailing address:
  • Phone: 502-804-5495
  • Fax: 833-563-1715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN0000150128
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000015136
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: