Healthcare Provider Details

I. General information

NPI: 1891902904
Provider Name (Legal Business Name): NATIONAL NEUROPHYSIOLOGY INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 11/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12123 SHELBYVILLE RD #302
LOUISVILLE KY
40243-1345
US

IV. Provider business mailing address

12123 SHELBYVILLE RD #302
LOUISVILLE KY
40243-1345
US

V. Phone/Fax

Practice location:
  • Phone: 502-338-1255
  • Fax: 866-403-7977
Mailing address:
  • Phone: 502-338-1255
  • Fax: 866-403-7977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: HONG YAN
Title or Position: PRESIDENT
Credential:
Phone: 502-338-1255