Individual
ALISON MORTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 E CHESTNUT ST BLDG STE 303, LOUISVILLE, KY 40202-1831
(502) 629-5552
(502) 629-3132
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
51450
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300025162
—
IN
05
—
7100360950
—
KY
01
—
K272690
MEDICARE
KY
Enumeration date
03/25/2014
Last updated
09/21/2022
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