Organization · NPI-2
Welgen One Of Kentucky LLC
General Practice · Louisville, KY
NPI number1083347827
StatusActive
Last updated in NPPESNov 4, 2022
Details
- NPI
- 1083347827
- Entity type
- Organization (NPI-2)
- Legal business name
- Welgen One Of Kentucky LLC
- Organization subpart
- No
- Enumeration date
- Jul 8, 2022
- Certification date
- Nov 4, 2022
- Last updated
- Nov 4, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
| 101Y00000X | Counselor | – | – | |
| 207KI0005X | Allergy & Immunology, Clinical & Laboratory Immunology | – | – | |
| 246YR1600X | Spec/Tech, Health Info, Registered Record Administrator | – | – | |
| 363L00000X | Nurse Practitioner | – | – |
Practice location
629 S 4th St Ste 301Louisville, KY 40202-2461
Phone 833-935-4361
Mailing address
629 S 4th St Ste 301Louisville, KY 40202-2461
Phone 833-935-4361
Authorized official
Shanira Delacruz
President
2012332155
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