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General NPI Number Information
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NPI Number | 1679074215
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Entity Type | Organization
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Legal Business Name | CLEAR EARS
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Dates
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Enumeration Date | 02/27/2018
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Last Update Date | 07/13/2018
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Provider Practice Location Address
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Address Line | 9503 NORTON COMMONS BLVD
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City | PROSPECT
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State | KY
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Zip | 40059
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Country | US
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Telephone | 502-767-8224
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Fax |
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Provider Business Mailing Address
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Address Line | 9503 NORTON COMMONS BLVD
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City | PROSPECT
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State | KY
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Zip | 40059-7522
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Country | US
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Telephone | 502-767-8224
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | KELLIE JUDE SHEEHY
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Credential | APRN
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Telephone | 502-767-8224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | KY
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