Healthcare Provider Details

I. General information

NPI: 1023908696
Provider Name (Legal Business Name): ESTHER BEARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2025
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 EVERGREEN RD
LOUISVILLE KY
40243-1010
US

IV. Provider business mailing address

3101 ANNADALE CT
LOUISVILLE KY
40299-4492
US

V. Phone/Fax

Practice location:
  • Phone: 502-209-9178
  • Fax:
Mailing address:
  • Phone: 502-257-2355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-318546
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: