Loraine Ruth Condrey
Nurse Practitioner - Pediatrics
3015 Wilson Ave
Louisville
, Kentucky 40211-1969
Loraine Ruth Condrey
Nurse Practitioner - Pediatrics
3015 Wilson Ave
Louisville
, Kentucky 40211-1969
(502) 774-4401
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About
Features
Specialties
- Nurse Practitioner - Pediatrics
Languages spoken
- English
Location
First Address
- Loraine Ruth Condrey
- 3015 Wilson Ave
- Louisville, KY
- Zip : 40211-1969
- Phone : (502) 774-4401
Second Address
- Loraine Ruth Condrey
- 3015 Wilson Ave
- Louisville, KY
- Zip : 40211-1969
- Phone : (502) 774-4401
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP0200X | Nurse Practitioner - Pediatrics | 3009488 | KY |
National Provider Identifier
| NPI | 1043622533 |
|---|---|
| Provider Name | Loraine Ruth Condrey |
| First Address | Louisville, KY 40211-1969 |
| Second Address | Louisville, KY 40211-1969 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/06/2014 |
| Last Update Date | 20/07/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 7100362900 | (05) | KY |
| K190270 | MEDICARE (01) | KY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.