MEDICARE: LAURA INABNITT DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	R4744	KY
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207Q00000X	Family Medicine Physician	TP222	KY

General Provider Information

NPI Number	:	1114414273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA INABNITT DO

Provider Business Mailing Address
First Line	:	PO BOX 1080
Second Line	:
City	:	BURKESVILLE
State	:	KY
Zip	:	42717-1080
Country	:	US
Telephone Number	:	270-864-1472
Fax Number	:	270-858-4607

Provider Business Practice Location Address
First Line	:	1515 EDMONTON RD
Second Line	:
City	:	TOMPKINSVILLE
State	:	KY
Zip	:	42167-9402
Country	:	US
Telephone Number	:	270-487-9272
Fax Number	:	270-487-6242

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2018
Last Update Date	:	07/07/2021

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