Organization · NPI-2
360care Services Of Kentucky LLC
Nurse Practitioner · Louisville, KY
NPI number1174394852
StatusActive
Last updated in NPPESJan 11, 2024
Details
- NPI
- 1174394852
- Entity type
- Organization (NPI-2)
- Legal business name
- 360care Services Of Kentucky LLC
- Organization subpart
- No
- Enumeration date
- Jan 11, 2024
- Certification date
- Jan 11, 2024
- Last updated
- Jan 11, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | – | – | Yes |
Practice location
12910 Shelbyville Rd Ste 300Louisville, KY 40243-2404
Phone 248-528-2116 · Fax 502-996-8282
Mailing address
12910 Shelbyville Rd Ste 300Louisville, KY 40243-2404
Phone 248-528-2116 · Fax 502-996-8282
Authorized official
Joy L Stevens
Director Of Revenue
5022442441
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