Organization
COMMONWEALTH FAMILY CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA KELLY WHITE APRN (PRESIDENT)
(502) 403-0007
Entity
Organization
Contact information
Practice address
7410 NEW LA GRANGE RD, SUITE 125, LOUISVILLE, KY 40222-4871
(502) 742-0460
(502) 742-9340
Mailing address
7410 NEW LA GRANGE RD, SUITE 125, LOUISVILLE, KY 40222-4871
(502) 742-0460
(502) 742-9340
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3002841
KY
363LF0000X
Family Nurse Practitioner
3006986
KY
Other
Enumeration date
01/25/2016
Last updated
12/15/2016
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