Healthcare Provider Details

I. General information

NPI: 1821534546
Provider Name (Legal Business Name): CRYSTAL FAITH LABBATO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2017
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 DUTCHMANS LN
LOUISVILLE KY
40205-3271
US

IV. Provider business mailing address

6200 DUTCHMANS LN
LOUISVILLE KY
40205-3271
US

V. Phone/Fax

Practice location:
  • Phone: 502-456-6200
  • Fax: 502-456-6655
Mailing address:
  • Phone: 502-456-6200
  • Fax: 502-456-6655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number3011044
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number3011044
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number3011044
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: