Provider Demographics
NPI:1194123687
Name:NORTHERN KENTUCKY UNIVERSITY FOUNDATION INC.
Entity type:Organization
Organization Name:NORTHERN KENTUCKY UNIVERSITY FOUNDATION INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PFENDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-912-0597
Mailing Address - Street 1:206 ALBRIGHT HEALTH CTR
Mailing Address - Street 2:NORTHERN KY UNIVERSITY
Mailing Address - City:NEWPORT
Mailing Address - State:KY
Mailing Address - Zip Code:41099-0001
Mailing Address - Country:US
Mailing Address - Phone:859-572-5579
Mailing Address - Fax:859-572-1934
Practice Address - Street 1:206 ALBRIGHT HEALTH CTR
Practice Address - Street 2:NORTHERN KY UNIVERSITY
Practice Address - City:NEWPORT
Practice Address - State:KY
Practice Address - Zip Code:41099-0001
Practice Address - Country:US
Practice Address - Phone:859-572-5579
Practice Address - Fax:859-572-1934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-15
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty