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Individual

MRS. BRITTNEY LEIGH VAN LAEKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGACNP-BC

Contact information

Practice address
2500 N ELM ST, HENDERSON, KY 42420-2005
(731) 394-1145
Mailing address
PO BOX 19599, BELFAST, ME 04915-4090
(731) 394-1145

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
3018986
KY
363LG0600X
Gerontology Nurse Practitioner
71011790A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000001600733
BCBS
05
300056307
IN
05
7100777640
KY
01
71011790
INDIANA STATE LICENSE
IN
Enumeration date
08/16/2021
Last updated
03/07/2023
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