Provider Demographics
NPI:1063968576
Name:NOEL, LAURA M
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:M
Last Name:NOEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 S PRESTON ST FL 2
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-2319
Mailing Address - Country:US
Mailing Address - Phone:502-583-1799
Mailing Address - Fax:502-583-1792
Practice Address - Street 1:721 S PRESTON ST FL 2
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-2319
Practice Address - Country:US
Practice Address - Phone:502-583-1799
Practice Address - Fax:502-583-1792
Is Sole Proprietor?:No
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010673363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner