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General NPI Number Information
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NPI Number | 1417589706
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Entity Type | Individual
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Provider Name | ADAM PREWITT APRN
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Gender | Male
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Dates
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Enumeration Date | 02/05/2020
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Last Update Date | 01/19/2021
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Provider Practice Location Address
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Address Line | 100 LONDON MOUNTAIN VIEW DR FL 1
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City | LONDON
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State | KY
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Zip | 40741-6668
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Country | US
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Telephone | 859-275-5229
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Fax | 859-977-2683
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Provider Business Mailing Address
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Address Line | 223 EXECUTIVE PARK
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City | LOUISVILLE
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State | KY
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Zip | 40207
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Country | US
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Telephone | 502-907-0356
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Fax | 502-919-9780
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3014139
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License Number State | KY
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