Healthcare Provider Details

I. General information

NPI: 1285185546
Provider Name (Legal Business Name): DIANE KAYE SAWYER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2016
Last Update Date: 02/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3903 VANTAGE PL
LOUISVILLE KY
40299-6801
US

IV. Provider business mailing address

4000 FAIRFIELD GARDENS COURT
LOUISVILLE KY
40245
US

V. Phone/Fax

Practice location:
  • Phone: 502-356-4377
  • Fax: 888-959-2460
Mailing address:
  • Phone: 502-243-1169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3010663
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: