Individual
ALLISON MCKENZIE THEOBALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
6500 PRESTON HWY, LOUISVILLE, KY 40219-1820
(502) 893-5502
Mailing address
6500 PRESTON HWY, LOUISVILLE, KY 40219-1820
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
3012345
KY
Other
Enumeration date
10/18/2018
Last updated
10/27/2020
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