Healthcare Provider Details

I. General information

NPI: 1164805701
Provider Name (Legal Business Name): LAURIE B ROBINSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2015
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7926 PRESTON HWY STE 106
LOUISVILLE KY
40219-3848
US

IV. Provider business mailing address

2700 STANLEY GAULT PKWY STE 129
LOUISVILLE KY
40223-5176
US

V. Phone/Fax

Practice location:
  • Phone: 502-964-4357
  • Fax:
Mailing address:
  • Phone: 502-253-4900
  • Fax: 502-489-5751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3009279
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number3009379
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3009279
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: