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Individual

TAYLOR C THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
4423 BARDSTOWN ROAD, LOUISVILLE, KY 40218
(502) 495-2400
(502) 495-6345
Mailing address
100 E LIBERTY STREET SUITE 800, LOUISVILLE, KY 40202-1428
(502) 540-3387
(502) 540-3393

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3013766
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100621730
KY
01
K287280
MEDICARE
KY
Enumeration date
08/21/2019
Last updated
10/01/2019
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