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Individual

LAURA M GREENE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
483 S LOOP RD, EDGEWOOD, KY 41017-5446
(859) 301-4600
(859) 301-4601
Mailing address
483 S LOOP RD, EDGEWOOD, KY 41017-5446
(859) 301-4600
(859) 301-4601

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2778P
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000335133
ANTHEM
KY
05
78009214
KY
Enumeration date
07/19/2005
Last updated
06/06/2013
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