Individual
JULIA K PROHASKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4402 CHURCHMAN AVE, SUITE 300, LOUISVILLE, KY 40215-1190
(502) 363-0588
(502) 363-0972
Mailing address
100 E LIBERTY ST, STE 800, LOUISVILLE, KY 40202-1428
(502) 363-0588
(502) 363-0972
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA246
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100089540
—
KY
01
—
P00752643
MEDICARE RR
KY
01
—
PA246
KY MED. LICENSE
KY
Enumeration date
05/28/2007
Last updated
06/29/2018
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