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General NPI Number Information
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NPI Number | 1194123687
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Entity Type | Organization
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Legal Business Name | NORTHERN KENTUCKY UNIVERSITY FOUNDATION INC.
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Dates
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Enumeration Date | 12/15/2014
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Last Update Date | 12/15/2014
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Provider Practice Location Address
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Address Line | 206 ALBRIGHT HEALTH CTR NORTHERN KY UNIVERSITY
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City | NEWPORT
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State | KY
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Zip | 41099-0001
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Country | US
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Telephone | 859-572-5579
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Fax | 859-572-1934
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Provider Business Mailing Address
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Address Line | 206 ALBRIGHT HEALTH CTR NORTHERN KY UNIVERSITY
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City | NEWPORT
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State | KY
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Zip | 41099-0001
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Country | US
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Telephone | 859-572-5579
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Fax | 859-572-1934
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Authorized Official
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Title or Position | DIRECTOR
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Name | KRIS PFENDT
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Credential |
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Telephone | 859-912-0597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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