Deaudra Pulliam, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

94689 Issued in TN

Practice address

4157 Hale Ave
Louisville, KY 40211-2557

Phone

(615) 497-6906

NPI assigned

Feb 27, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Deaudra Pulliam Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1447016373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4157 HALE AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402112557",
            "telephone_number": "615-497-6906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4157 HALE AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402112557",
            "telephone_number": "615-497-6906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLIAM",
        "first_name": "DEAUDRA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "94689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEAUDRA",
            "last_name": "PULLIAM",
            "credential": "LPN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Carly Justine Pujol, DPT
• Vladimir Pulgaron, MD
• David Pullem
• Kelly Ann Marie Pullen, MSSW, LCSW
• Apeksha Reddy Pulliahgaru, M.B.B.S., M.D.
• Pulmonary Specialists of Louisville, PSC
• Pulsemer Care LLC
• Pulsemer Health LLC
• Gwendolyn Pumphrey
• Tamela Pumphrey

• Licensed Practical Nurse in Louisville, KY
• Providers in Louisville, KY by specialty
• Licensed Practical Nurse in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.