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General NPI Number Information
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NPI Number | 1689280216
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Entity Type | Organization
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Legal Business Name | HMPS INTERNAL MEDICINE OF WEST LOUISVILLE PLLC
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Dates
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Enumeration Date | 09/18/2020
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Last Update Date | 08/27/2021
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Provider Practice Location Address
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Address Line | 927 W MAIN ST
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City | LOUISVILLE
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State | KY
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Zip | 40202-2621
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Country | US
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Telephone | 502-618-4298
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Fax |
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Provider Business Mailing Address
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Address Line | 927 W MAIN ST
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City | LOUISVILLE
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State | KY
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Zip | 40202-2621
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Country | US
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Telephone | 502-618-4298
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Fax |
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Authorized Official
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Title or Position | APRN
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Name | JENNIFER A HAYNES
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Credential | APRN
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Telephone | 502-548-7791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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