Healthcare Provider Details

I. General information

NPI: 1508282211
Provider Name (Legal Business Name): AUNDRIA RADMACHER LCPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2014
Last Update Date: 09/13/2020
Certification Date: 09/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 WALLACE AVE STE 313
LOUISVILLE KY
40207-3007
US

IV. Provider business mailing address

311 WALLACE AVE STE 313
LOUISVILLE KY
40207-3007
US

V. Phone/Fax

Practice location:
  • Phone: 502-418-1528
  • Fax:
Mailing address:
  • Phone: 502-418-1528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number9000012
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: