Individual
VICKI J DESILETS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
200 ABRAHAM FLEXNER WAY, LOUISVILLE, KY 40202-1818
(502) 587-4203
(502) 587-4155
Mailing address
100 E LIBERTY ST STE 800, LOUISVILLE, KY 40202-1428
(502) 587-4404
(502) 587-4156
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3003083
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200255020A
—
IN
05
—
74001355
—
KY
Enumeration date
12/05/2006
Last updated
04/05/2018
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