Individual
MS. MARY A DEMURO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
530 S JACKSON ST, ROOM A3G11, LOUISVILLE, KY 40202-1675
(502) 852-5237
Mailing address
2712 FLAT ROCK RD, LOUISVILLE, KY 40245-4860
(502) 241-5049
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4062P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200427960
—
KY
01
—
4062P
ARNP LISCENSE
KY
Enumeration date
07/17/2006
Last updated
07/08/2007
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