Healthcare Provider Details

I. General information

NPI: 1144998212
Provider Name (Legal Business Name): LAURA ELIZABETH DAVIS MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2021
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 S FLOYD ST STE 200
LOUISVILLE KY
40202-1840
US

IV. Provider business mailing address

PO BOX 776347
CHICAGO IL
60677-6347
US

V. Phone/Fax

Practice location:
  • Phone: 502-629-2500
  • Fax: 502-629-4445
Mailing address:
  • Phone: 502-588-9490
  • Fax: 502-272-5116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0029892
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3016745
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number498039
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1153778
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: