Individual
MARY KATHERINE BIROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
312 S 4TH ST STE 700, LOUISVILLE, KY 40202-3046
(502) 804-5495
(833) 563-1715
Mailing address
312 S 4TH ST STE 700, LOUISVILLE, KY 40202-3046
(502) 804-5495
(833) 563-1715
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3011457
KY
363LA2200X
Adult Health Nurse Practitioner
3011457
KY
363LA2200X
Adult Health Nurse Practitioner
Primary
71010577
IN
363LG0600X
Gerontology Nurse Practitioner
3011457
KY
363LG0600X
Gerontology Nurse Practitioner
71010577
IN
363LP2300X
Primary Care Nurse Practitioner
3011457
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14388820
CAQH
—
05
—
300044749
—
IN
05
—
7100603430
—
KY
Enumeration date
06/03/2018
Last updated
11/16/2024
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