Individual
KORA MCMAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1700 CARGO CT, LOUISVILLE, KY 40299-1938
(502) 681-5356
Mailing address
391 CRESTWOOD LN, LOUISVILLE, KY 40229-3324
(502) 681-5356
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2055772
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2055772
—
KY
Enumeration date
03/29/2021
Last updated
03/29/2021
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