Individual
DIAJIAH PHILIDOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1432 AVOCA RIDGE DR APT 103, LOUISVILLE, KY 40223-3289
(502) 616-0376
Mailing address
1432 AVOCA RIDGE DR APT 103, LOUISVILLE, KY 40223-3289
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4024038
KY
163WG0000X
General Practice Registered Nurse
Primary
4024038
KY
163WH0200X
Home Health Registered Nurse
4024038
KY
163WI0500X
Infusion Therapy Registered Nurse
4024038
KY
Other
Enumeration date
03/11/2025
Last updated
03/11/2025
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