MEDICARE: MRS. CARMEN DENENE BYARS ARNP-C

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	363LF0000X	Family Nurse Practitioner	3101P	KY

General Provider Information

NPI Number	:	1740389121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CARMEN DENENE BYARS ARNP-C

Provider Business Mailing Address
First Line	:	7416 E ORCHARD GRASS BLVD
Second Line	:
City	:	CRESTWOOD
State	:	KY
Zip	:	40014-9076
Country	:	US
Telephone Number	:	502-384-3272
Fax Number	:

Provider Business Practice Location Address
First Line	:	2529 SIX MILE LN
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40220-2934
Country	:	US
Telephone Number	:	502-491-5560
Fax Number	:

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

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	07/08/2007

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