Individual
ABBY JO LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
500 CLINIC DR, HOPKINSVILLE, KY 42240-4991
(270) 707-3354
(270) 707-3351
Mailing address
2700 STANLEY GAULT PKWY, SUITE 129, LOUISVILLE, KY 40223-5132
(270) 326-3949
(270) 326-3954
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3007353
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100200240
—
KY
Enumeration date
02/20/2012
Last updated
12/08/2020
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