Provider Demographics
NPI:1649041617
Name:NUHANOVIC, DZENITA (APRN)
Entity type:Individual
Prefix:MS
First Name:DZENITA
Middle Name:
Last Name:NUHANOVIC
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 RUNELL RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40214-4603
Mailing Address - Country:US
Mailing Address - Phone:502-759-8146
Mailing Address - Fax:
Practice Address - Street 1:218 HOWLE AVE STE A
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2449
Practice Address - Country:US
Practice Address - Phone:854-444-0518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4011224363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner