# LAURA KELLY CHISM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1366440091
- **Gender:** F
- **Credential:** APRN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 3002841 | KY | Yes |

## Other

- **Enumeration date:** 07/07/2005
- **Last updated:** 08/07/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000305963 | ANTHEM | KY |
| 01 | — | 000000861403 | ANTHEM-NSS | KY |
| 01 | — | 158653 | SIHO-NSS | KY |
| 01 | — | 2444403000 | PASSPORT ADVANTAGE | KY |
| 01 | — | 50002937 | PASSPORT | KY |
| 01 | — | 50064974 | PASSPORT-NSS | KY |
| 05 | — | 78004108 | — | KY |