Individual
MRS. LAURA M YEAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4123 DUTCHMANS LN STE 101, LOUISVILLE, KY 40207-4718
(502) 899-6782
(502) 899-6783
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 272-5063
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3007697
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000794630
ANTHEM BC/BS
KY
05
—
201018200
—
IN
01
—
3007697
LICENSE
KY
01
—
50045064
PASSPORT
KY
05
—
7100224020
—
KY
Enumeration date
09/21/2012
Last updated
03/07/2023
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