Individual
DONNA CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3940 DUPONT CIR, LOUISVILLE, KY 40207-4806
(502) 895-1111
(502) 895-1085
Mailing address
6801 DIXIE HWY, SUITE 130, LOUISVILLE, KY 40258-3913
(502) 895-1111
(502) 895-1085
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
3002353
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78005790
—
KY
Enumeration date
08/31/2005
Last updated
06/21/2012
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