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Individual

MRS. CARRIE LIANNE YUDA THONEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1900 BLUEGRASS AVE STE 300, LOUISVILLE, KY 40215-1183
(502) 977-5907
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0325

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
127268
CO
363LW0102X
Women's Health Nurse Practitioner
Primary
3006638
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000933022
ANTHEM
KY
05
11301830
CO
01
50086583
PASSPORT
KY
01
5395790
AETNA
KY
05
7100142980
KY
Enumeration date
08/30/2006
Last updated
11/12/2021
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