Healthcare Provider Details

I. General information

NPI: 1770820060
Provider Name (Legal Business Name): PATIENTS 1ST EXTENDED HOURS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2013
Last Update Date: 04/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 DORSEY WAY
LOUISVILLE KY
40223-2836
US

IV. Provider business mailing address

508 DORSEY WAY
LOUISVILLE KY
40223-2836
US

V. Phone/Fax

Practice location:
  • Phone: 502-327-8775
  • Fax:
Mailing address:
  • Phone: 502-327-8775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number3007101
License Number StateKY

VIII. Authorized Official

Name: ANDREA M HUEY
Title or Position: FAMILY NURSE PRACTITIONER
Credential: APRN
Phone: 502-327-8775