1790709236 NPI number — MS. LAURA M TUDOR ARNP

Table of content: MS. LAURA M TUDOR ARNP (NPI 1790709236)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790709236 NPI number — MS. LAURA M TUDOR ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TUDOR
Provider First Name:
LAURA
Provider Middle Name:
M
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
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:
1790709236
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/04/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2700 STANLEY GAULT PKWY STE 129
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:
40223-5176
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-489-6613
Provider Business Mailing Address Fax Number:
502-489-5751

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3900 KRESGE WAY
Provider Second Line Business Practice Location Address:
SUITE 51
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-259-5955
Provider Business Practice Location Address Fax Number:
502-259-5953
Provider Enumeration Date:
07/27/2006

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: 363L00000X , with the licence number:  3004491 , 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: 200893710 . This is a "ANTHEM INDIANA MEDICAID- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000023035L . This is a "HUMANA- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 78016110 . This is a "MEDICAID KY- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: P00706053 . This is a "RAILROAD MEDICARE- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 102637 . This is a "SIHO- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 200893710 . This is a "MD WISE- NNIKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 200893710 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200893710 . This is a "HEALTHY INDIANA PLAN- NNIKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 200893710 . This is a "MANAGED HEALTH SERVICES- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 2170111 . This is a "CIGNA- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 50022597 . This is a "PASSPORT- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000507656 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00533107 . This is a "ANTHEM- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 00533107 . This is a "MEDICARE- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 3697392000 . This is a "PASSPORT ADVANTAGE- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com