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Individual

VICKY L RAISOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
4200 GARDINER VIEW AVE STE 101, LOUISVILLE, KY 40213-1877
(502) 456-0494
(502) 456-0496
Mailing address
4200 GARDINER VIEW AVE STE 101, LOUISVILLE, KY 40213-1877
(502) 456-0494
(502) 456-0496

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3009998
KY

Other

Enumeration date
01/06/2016
Last updated
01/06/2016
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