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General NPI Number Information
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NPI Number | 1366163685
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Entity Type | Organization
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Legal Business Name | KIDNEY DISEASE CONSULTANTS
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Dates
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Enumeration Date | 09/06/2022
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 47 CAVALIER BLVD STE 120
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City | FLORENCE
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State | KY
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Zip | 41042-3970
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Country | US
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Telephone | 859-757-4353
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Fax | 859-534-0865
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Provider Business Mailing Address
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Address Line | 47 CAVALIER BLVD STE 120
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City | FLORENCE
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State | KY
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Zip | 41042-3970
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Country | US
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Telephone | 859-757-4353
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Fax | 859-534-0865
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | SHERRIE LYNN MYERS
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Credential |
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Telephone | 859-757-4353
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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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