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General NPI Number Information
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NPI Number | 1659868107
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Entity Type | Organization
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Legal Business Name | NORTON HEALTHCARE
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Dates
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Enumeration Date | 04/19/2018
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Last Update Date | 04/19/2018
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Provider Practice Location Address
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Address Line | 1930 BISHOP LN
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City | LOUISVILLE
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State | KY
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Zip | 40218-1921
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Country | US
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Telephone | 502-272-5044
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Fax |
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Provider Business Mailing Address
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Address Line | 2308 HIKES LN APT E38
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City | LOUISVILLE
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State | KY
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Zip | 40218-1426
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | APRN
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Name | KENQUISHA MARIE MOORMAN
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Credential | FNP-C
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Telephone | 502-417-3044
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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 | 3012039
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License Number State | KY
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