Individual
MRS. MEREDITH HAEDTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
529 S JACKSON ST, LOUISVILLE, KY 40202-3229
(502) 562-4060
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3013792
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100666040
—
KY
Enumeration date
02/10/2020
Last updated
03/03/2022
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