1619338993 NPI number — MRS. RUTH ELLEN BARONE MSN, APRN, FNP-BC

Table of content: MRS. RUTH ELLEN BARONE MSN, APRN, FNP-BC (NPI 1619338993)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619338993 NPI number — MRS. RUTH ELLEN BARONE MSN, APRN, FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARONE
Provider First Name:
RUTH
Provider Middle Name:
ELLEN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSN, APRN, FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619338993
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/08/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
223 EXECUTIVE PARK
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40207-4202
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-907-0356
Provider Business Mailing Address Fax Number:
502-919-9780

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
320 THOMAS MORE PKWY STE 202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CRESTVIEW HILLS
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41017-3456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
593-310-4328
Provider Business Practice Location Address Fax Number:
859-331-0956
Provider Enumeration Date:
03/14/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  COA.18905-NP , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 3010272 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0169555 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: PDZ000000084291 . This is a "AETNA BETTER HEALTH PIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7100542740 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 300014658 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000001184828 . This is a "ANTHEM PIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: CS1829700441 . This is a "CARESOURCE ID" identifier . This identifiers is of the category "OTHER".




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