Individual
MRS. KRISTA GAIL ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
422 HEYWOOD AVE, LOUISVILLE, KY 40208-1346
(502) 636-3133
Mailing address
422 HEYWOOD AVE, LOUISVILLE, KY 40208-1346
(502) 636-3133
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3009011
KY
363LF0000X
Family Nurse Practitioner
3009011
KY
363LW0102X
Women's Health Nurse Practitioner
3009011
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100312960
—
KY
Enumeration date
10/31/2014
Last updated
07/14/2023
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