Doctor Name: | TARA R. APPLEGATE |
NPI Number: | 1447611652 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 3010178 |
Business Practice Address: | 1210 Ky Highway 36 E Suite 2c Cynthiana, KY - 410317490 |
Business Phone Number: | 8592346000 |
Business Fax Number: | 8592346011 |
Mailing Address: | 1210 Ky Highway 36 E, Suite 2c CYNTHIANA |
State: | KY |
Postal Code: | 410317490 |
Phone Number: | 8592346000 |
Fax Number: | 8592346011 |
NPI Enumeration Date: | 03/15/2016 |
NPI Last Update Date: | 03/15/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 3010178 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |