Healthcare Provider Details

I. General information

NPI: 1811705536
Provider Name (Legal Business Name): ANRRIECH TAMARA MILAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2024
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 POPLAR LEVEL RD
LOUISVILLE KY
40213-1076
US

IV. Provider business mailing address

2218 HIGHLAND SPRINGS PL
LOUISVILLE KY
40245-5286
US

V. Phone/Fax

Practice location:
  • Phone: 502-636-7444
  • Fax:
Mailing address:
  • Phone: 502-712-3029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number258690
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: