Individual
TARA S KAUFFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3900 KRESGE WAY, SUITE 60, LOUISVILLE, KY 40207-4660
(502) 893-7710
(502) 893-1884
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 489-5730
(502) 489-5753
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3005457
KY
363L00000X
Nurse Practitioner
44683
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000525603
ANTHEM PIN
KY
01
—
000000693050
ANTHEM - NCVA
KY
01
—
000057080U
HUMANA - NCVA
KY
01
—
122021
SIHO - NCVA
KY
05
—
7100146890
—
KY
01
—
P00992184
RR MEDICARE KY
KY
Enumeration date
07/13/2007
Last updated
12/07/2020
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