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NPI Code Detail

MEDICARE: LAURA M GREENE NP

MEDICARE: LAURA M GREENE NP
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
1363LF0000XFamily Nurse Practitioner2778PKY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000335133OTHERKYANTHEM

General Provider Information

NPI Number : 1831198126
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA M GREENE NP
Provider Business Mailing Address
First Line : 483 S LOOP RD
Second Line :
City : EDGEWOOD
State : KY
Zip : 41017-5446
Country : US
Telephone Number : 859-301-4600
Fax Number : 859-301-4601
Provider Business Practice Location Address
First Line : 483 S LOOP RD
Second Line :
City : EDGEWOOD
State : KY
Zip : 41017-5446
Country : US
Telephone Number : 859-301-4600
Fax Number : 859-301-4601
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 06/06/2013

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