Individual
DR. KRISTEN LYNNE RABAUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
12911 SHELBYVILLE RD, LOUISVILLE, KY 40243-1613
(502) 254-1100
(502) 254-7634
Mailing address
12911 SHELBYVILLE RD, LOUISVILLE, KY 40243-1613
(502) 254-1100
(502) 254-7634
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1705DT
KY
152W00000X
Optometrist
18003459
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000567489
ANTHEM BCBS
—
05
—
7100042720
—
KY
01
—
P00683702
RAILROAD MEDICARE
KY
Enumeration date
08/08/2007
Last updated
02/19/2014
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