St Luke Pediatric Center

Organization Active NPI Pediatric Nurse Practitioner · Bellevue, KY

NPI 1104087196 · NPPES record last updated Jun 23, 2008

Key facts

NPI
1104087196
Entity type
Organization (NPI type 2)
Primary specialty
Pediatric Nurse Practitioner 363LP0200X
Legal business name
ST LUKE PEDIATRIC CENTER
Practice address
103 Landmark Dr Ste 360
Bellevue, KY 41073-1354
Phone
(859) 261-3700
Fax
(859) 261-9788
NPI assigned
Jun 23, 2008
Organization subpart
No

Authorized official

Name
Mrs. Stephanie Sanchez, CPC
Title
Coder
Phone
(859) 261-3700

Corporate family (same tax ID) 11

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
St Luke Hospitals Inc (12 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LP0200X Yes

Addresses

Primary practice location

103 Landmark Dr Ste 360
Bellevue, KY 41073-1354

Mailing address

103 Landmark Dr Ste 360
Bellevue, KY 41073-1354
Phone (859) 261-3700

Other identifiers

IdentifierTypeStateIssuer
65915621MedicaidKY
78901709OtherKYMEDICAID NP GROUP

Other providers in Bellevue, KY

All providers in Bellevue, KY · Pediatric Nurse Practitioner in Kentucky

Sources for this page

Verify at the official NPI Registry.