Healthcare Provider Details

I. General information

NPI: 1194838391
Provider Name (Legal Business Name): PAULINE SANDRA KUHBANDER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 10/06/2023
Certification Date: 10/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1357 BARDSTOWN RD
LOUISVILLE KY
40204-1353
US

IV. Provider business mailing address

5407 APACHE RD
LOUISVILLE KY
40207-1611
US

V. Phone/Fax

Practice location:
  • Phone: 502-897-6443
  • Fax:
Mailing address:
  • Phone: 502-897-6997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3895P
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: