Individual
TAKEYSHA BALDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1802 HARDESTY AVE, LOUISVILLE, KY 40216-5316
(502) 994-1318
Mailing address
1802 HARDESTY AVE, LOUISVILLE, KY 40216-5316
(502) 994-1318
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2036300
KY
Other
Enumeration date
04/03/2023
Last updated
04/03/2023
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