Individual
LIDUVINA ISABEL DECARLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
7926 PRESTON HWY STE 103, LOUISVILLE, KY 40219-3848
(502) 861-4652
(502) 272-5116
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
3015158
KY
363LF0000X
Family Nurse Practitioner
Primary
3015158
KY
Other
Enumeration date
02/15/2021
Last updated
03/28/2024
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