Provider Demographics
NPI:1891927943
Name:NEONATAL INTENSIVE CARE EXPERTS, PLLC
Entity type:Organization
Organization Name:NEONATAL INTENSIVE CARE EXPERTS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-452-1916
Mailing Address - Street 1:4121 DUCTCHMAN'S LANE
Mailing Address - Street 2:STE 301
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207
Mailing Address - Country:US
Mailing Address - Phone:502-896-2500
Mailing Address - Fax:502-896-2527
Practice Address - Street 1:4121 DUCTCHMAN'S LANE
Practice Address - Street 2:STE 301
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207
Practice Address - Country:US
Practice Address - Phone:502-896-2500
Practice Address - Fax:502-896-2527
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEONATAL INTENSIVE CARE EXPERTS, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty