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General NPI Number Information
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NPI Number | 1528982279
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Entity Type | Organization
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Legal Business Name | 360CARE PRIMARY CARE LLC
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 4350 BROWNSBORO RD STE 210
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City | LOUISVILLE
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State | KY
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Zip | 40207-1681
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Country | US
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Telephone | 502-244-2420
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Fax | 502-996-8282
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Provider Business Mailing Address
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Address Line | 4350 BROWNSBORO RD STE 210
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City | LOUISVILLE
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State | KY
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Zip | 40207-1681
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Country | US
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Telephone | 502-579-1797
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Fax | 502-996-8282
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | JOHN DADDS
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Credential |
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Telephone | 502-244-2435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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