Individual
ETHEL DARLINE LUSTER CALDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
870 TAYLORSVILLE ROAD, TAYLORSVILLE, KY 40071
(502) 477-8888
(502) 477-2300
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 489-5730
(502) 489-5753
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3004768
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000524808
ANTHEM
KY
01
—
4768P
ARNP LIC#
KY
05
—
71000363800
—
KY
Enumeration date
05/22/2006
Last updated
01/26/2015
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