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General NPI Number Information
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NPI Number | 1699117226
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Entity Type | Organization
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Legal Business Name | AT YOUR DOOR MOBILE MEDICAL PLLC
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Dates
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Enumeration Date | 07/24/2013
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Last Update Date | 07/24/2013
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Provider Practice Location Address
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Address Line | 340 CHAPEZE LN
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City | SHEPHERDSVILLE
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State | KY
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Zip | 40165-8893
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Country | US
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Telephone | 502-921-2963
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Fax | 502-921-2963
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Provider Business Mailing Address
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Address Line | 340 CHAPEZE LN
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City | SHEPHERDSVILLE
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State | KY
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Zip | 40165-8893
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Country | US
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Telephone | 502-921-2963
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Fax | 502-921-2963
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Authorized Official
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Title or Position | MEMBER MANAGER
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Name | MRS. EMILY ANNE BAILEY
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Credential |
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Telephone | 502-921-2963
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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 | 3004234
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License Number State | KY
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