Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 25882 | KY |
NPI | 1053315853 |
---|---|
Provider Name | Dr. Karen Marie Erbeck |
First Address | Louisville, KY 40205-3340 |
Second Address | Louisville, KY 40205-3340 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 29/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000326249 | ANTHEM (01) | KY |
50003431 | PASSPORT (01) | KY |
64258825 | (05) | KY |
F20496 | (02) | KY |