Healthcare Provider Details

I. General information

NPI: 1467732800
Provider Name (Legal Business Name): DAVID G PRICE APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2011
Last Update Date: 10/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

571 S FLOYD ST STE 342
LOUISVILLE KY
40202-3818
US

IV. Provider business mailing address

PO BOX 909
LOUISVILLE KY
40201-0909
US

V. Phone/Fax

Practice location:
  • Phone: 502-852-8470
  • Fax:
Mailing address:
  • Phone: 502-588-0329
  • Fax: 502-588-0326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number3007044
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: