Healthcare Provider Details

I. General information

NPI: 1467547539
Provider Name (Legal Business Name): CAROLE PROCTOR WHITLEDGE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ZORN AVE
LOUISVILLE KY
40206-1433
US

IV. Provider business mailing address

9016 COLLINGWOOD RD
LOUISVILLE KY
40299-1419
US

V. Phone/Fax

Practice location:
  • Phone: 502-287-5894
  • Fax:
Mailing address:
  • Phone: 502-287-5894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0100X
TaxonomyGastroenterology Registered Nurse
License Number1033972
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number2886P
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: