Healthcare Provider Details

I. General information

NPI: 1144769944
Provider Name (Legal Business Name): RODNIKA FLOYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

3149 COMMERCE CENTER PL
LOUISVILLE KY
40211-1975
US

IV. Provider business mailing address

832 S 6TH ST
LOUISVILLE KY
40203-2124
US

V. Phone/Fax

Practice location:
  • Phone: 502-774-3337
  • Fax:
Mailing address:
  • Phone: 502-709-4599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: