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Individual

MARISA L CRENSHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
5722 OUTER LOOP, LOUISVILLE, KY 40219-4156
(502) 921-0222
(502) 921-0222
Mailing address
5722 OUTER LOOP, LOUISVILLE, KY 40219-4156
(502) 921-0222
(502) 921-0222

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3007792
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201258840
IN
05
7100230720
KY
Enumeration date
05/12/2008
Last updated
11/02/2023
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