Individual
CHARLES B FLORENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
315 E BROADWAY, SUITE 195, LOUISVILLE, KY 40202-3700
(502) 629-4263
(502) 629-4282
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1092268
KY
163W00000X
Registered Nurse
28156953A
IN
363L00000X
Nurse Practitioner
Primary
3004190
KY
363L00000X
Nurse Practitioner
4190P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000883797
ANTHEM-LAH
KY
01
—
162148
SIHO
KY
01
—
50076093
PASSPORT-LAH
KY
05
—
78017803
—
KY
Enumeration date
09/07/2005
Last updated
09/17/2021
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