MEDICARE: TWILIGHT CARE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1245820513
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TWILIGHT CARE PLLC

Provider Business Mailing Address
First Line	:	7205 KORT WAY
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40220-2769
Country	:	US
Telephone Number	:	502-641-1813
Fax Number	:	502-920-1463

Provider Business Practice Location Address
First Line	:	7205 KORT WAY
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40220-2769
Country	:	US
Telephone Number	:	502-641-1813
Fax Number	:	502-920-1463

Authorized Official
Title or Position	:	APRN/OWNER
Name	:	SANDRA M BUCHANAN
Credential	:	APRN
Telephone Number	:	502-641-1813

Provider Enumeration Date	:	01/21/2021
Last Update Date	:	01/21/2021

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