Individual
MARY CEIL LANHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
100 E LIBERTY ST, 7TH FLOOR, LOUISVILLE, KY 40202-1434
(502) 583-5836
(502) 583-2266
Mailing address
100 E LIBERTY ST, 7TH FLOOR, LOUISVILLE, KY 40202-1434
(502) 583-5836
(502) 583-2266
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3002585
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000214606
ANTHEM BCBS
KY
01
—
1152481
PASSPORT
KY
01
—
500021552
RAILROAD MEDICARE
KY
05
—
78003126
—
KY
Enumeration date
11/29/2005
Last updated
09/28/2021
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