Individual
TRISHA JEAN AGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4402 CHURCHMAN AVE, SUITE 300, LOUISVILLE, KY 40215-1190
(502) 363-0588
(502) 363-0972
Mailing address
100 E LIBERTY ST, SUITE 800, LOUISVILLE, KY 40202-1434
(502) 363-0588
(502) 363-0972
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-02273
NC
363A00000X
Physician Assistant
Primary
PA1801
KY
363AM0700X
Medical Physician Assistant
PA04863
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-02273
NCMB
NC
05
—
7100252770
—
KY
01
—
PA04863
STATE BOARD LICENSE NO.
TX
Enumeration date
12/29/2006
Last updated
06/04/2015
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