Individual
ELISE A. PUFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
100 MALLARD CREEK ROAD, SUITE 320, LOUISVILLE, KY 40207-5136
(502) 855-6125
(502) 394-1972
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3007619
KY
363LF0000X
Family Nurse Practitioner
3007619
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000923376
ANTHEM - NCMA
KY
01
—
172372
SIHO - NCMA
KY
01
—
50085461
PASSPORT - NCMA
KY
05
—
7100211130
—
KY
Enumeration date
08/20/2012
Last updated
08/09/2016
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