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General NPI Number Information
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NPI Number | 1033364252
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Entity Type | Individual
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Provider Name | LAUREN FLAHERTY PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/02/2008
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Last Update Date | 08/14/2018
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Provider Practice Location Address
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Address Line | 1 AUDUBON PLAZA DR
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City | LOUISVILLE
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State | KY
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Zip | 40217
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Country | US
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Telephone | 502-634-6767
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Fax | 502-634-6775
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Provider Business Mailing Address
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Address Line | PO BOX 36218
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City | LOUISVILLE
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State | KY
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Zip | 40233-6218
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Country | US
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Telephone | 502-634-6767
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Fax | 502-634-6775
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA1175
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License Number State | KY
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