Individual
LISA FAYE MAHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-NA
Contact information
Practice address
1850 BLUEGRASS AVE, LOUISVILLE, KY 40215-1161
(502) 361-6617
(502) 361-6637
Mailing address
100 E LIBERTY ST STE 800, LOUISVILLE, KY 40202-1428
(502) 631-6617
(502) 361-6637
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1080695
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
3007322
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000756782
ANTHEM BC/BS OF KY
KY
05
—
7100195050
—
KY
Enumeration date
12/15/2011
Last updated
04/19/2018
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