Individual
MARK DYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
12400 SHELBYVILLE RD, LOUISVILLE, KY 40243-1419
(502) 883-2218
Mailing address
506 EDGEFOREST PLACE, LOUISVILLE, KY 40245
(502) 845-6288
(502) 845-1000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3535P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78006376
—
KY
Enumeration date
12/08/2006
Last updated
07/21/2022
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