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Individual

LAURIE ROBERTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1010 MEDICAL CENTER DR, POWDERLY, KY 42367-5463
(270) 377-1600
(270) 326-4968
Mailing address
900 HOSPITAL DR, MADISONVILLE, KY 42431-1644
(270) 825-7200
(270) 326-4968

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3002916
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000186602
BCBS PROVIDER NUMBER
01
2916P
LICENSE
KY
05
78029162
KY
01
P01099331
RR MEDICARE- POWDERLY
KY
Enumeration date
09/17/2006
Last updated
03/12/2013
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