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General NPI Number Information
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NPI Number | 1720648850
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Entity Type | Organization
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Legal Business Name | TRISTATE BANP, LLC
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Dates
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Enumeration Date | 06/20/2019
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 5032 LOCH DR
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City | UNION
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State | KY
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Zip | 41091-1485
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Country | US
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Telephone | 859-640-3627
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 131
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City | UNION
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State | KY
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Zip | 41091-0131
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Country | US
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Telephone | 859-640-3627
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LISA AREHART
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Credential | APRN
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Telephone | 859-640-3627
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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 |
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License Number State |
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