Organization
ADVANCED DIABETES MANAGEMENT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL AINES APRN (OWNER)
(502) 592-9254
Entity
Organization
Contact information
Practice address
4119 BROWNS LN, BLDG 2, LOUISVILLE, KY 40220-1500
(800) 294-0807
(502) 681-9883
Mailing address
4119 BROWNS LN, BLDG 2, LOUISVILLE, KY 40220-1500
(800) 294-0807
(502) 681-9883
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100442930
—
KY
Enumeration date
05/27/2016
Last updated
03/06/2017
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