Individual
ANDREA BEAVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 S PRESTON ST, LOUISVILLE, KY 40202-1716
(502) 589-8600
(502) 589-8771
Mailing address
101 W MUHAMMAD ALI BLVD, LOUISVILLE, KY 40202-1423
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
20091515
KY
Other
Enumeration date
07/31/2009
Last updated
07/31/2009
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