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Individual

LAURA K BEITER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
3920 DUTCHMANS LN, LOUISVILLE, KY 40207-4702
(502) 259-6710
(502) 259-6704
Mailing address
3101 BRECKENRIDGE LN, SUITE 1A, LOUISVILLE, KY 40220-2742
(502) 458-7400
(502) 458-7449

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28171598A
IN
367500000X
Certified Registered Nurse Anesthetist
1103388
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
3004298
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000325671
ANTHEM BLUE SHIELD
KY
05
201352290
IN
01
2818456000
PASSPORT ADVANTAGE
KY
01
50013921
PASSPORT
KY
05
7100110460
KY
01
P00184515
RAILROAD MEDICARE
Enumeration date
10/03/2005
Last updated
04/26/2023
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