Provider Demographics
NPI:1548916158
Name:ABUNDANT RESOURCE HEALTH CARE PLLC
Entity type:Organization
Organization Name:ABUNDANT RESOURCE HEALTH CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:OHANIAN-SAMARIN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:502-376-4104
Mailing Address - Street 1:664 BYPASS RD
Mailing Address - Street 2:
Mailing Address - City:BRANDENBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40108-1730
Mailing Address - Country:US
Mailing Address - Phone:502-376-4104
Mailing Address - Fax:
Practice Address - Street 1:664 BYPASS RD
Practice Address - Street 2:
Practice Address - City:BRANDENBURG
Practice Address - State:KY
Practice Address - Zip Code:40108-1730
Practice Address - Country:US
Practice Address - Phone:502-376-4101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABUNDANT RESOURCE HEALTH CARE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-23
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty