Individual
AMANDA KRISTEN BLUME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4002 KRESGE WAY STE 124, LOUISVILLE, KY 40207-4664
(502) 259-3341
Mailing address
5200 COMMERCE CROSSINGS DR FL 3, LOUISVILLE, KY 40229-2182
(502) 253-4924
(502) 489-5750
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
3016667
KY
363LF0000X
Family Nurse Practitioner
Primary
3016667
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100792560
—
KY
01
—
K400500
MEDICARE
KY
Enumeration date
01/11/2022
Last updated
05/01/2024
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