Individual
MARY T ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
9510 ORMSBY STATION RD STE 100, LOUISVILLE, KY 40223-4082
(502) 327-1000
(855) 632-8329
Mailing address
9510 ORMSBY STATION RD STE 530, LOUISVILLE, KY 40223-4081
(502) 327-1000
(855) 632-8329
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3005543
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12166430
CAQH
—
05
—
7100150970
—
KY
Enumeration date
03/19/2008
Last updated
09/28/2018
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