Organization
GLADSTONE MOBILE HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATRICE ANDERSON RN, BSN, LMT (REGISTERED NURSE/OWNER)
(502) 888-9181
Entity
Organization
Contact information
Practice address
2500 W BROADWAY STE 100, LOUISVILLE, KY 40211-1184
(502) 888-9181
Mailing address
2500 W BROADWAY STE 100, LOUISVILLE, KY 40211-1184
(502) 888-9181
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/04/2021
Last updated
08/20/2021
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