Individual
LARA ELIZABETH BIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3900 KRESGE WAY STE 51, LOUISVILLE, KY 40207-4683
(502) 259-5955
(502) 259-5953
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 238-2801
(502) 238-2835
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1120718
KY
363L00000X
Nurse Practitioner
Primary
3008063
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201178280A
—
IN
05
—
7100247030
—
KY
Enumeration date
05/23/2013
Last updated
09/13/2023
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