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Vivian Lee Rakestraw
Family Nurse Practitioner in Louisville, Kentucky
NPI 1316975063

Vivian Lee Rakestraw is a Family Nurse Practitioner based in Louisville, KY and is specialized in Family. Vivian Lee Rakestraw practices in Louisville, KY. The NPI Number for Vivian Lee Rakestraw is 1316975063 and holds a License No. 4778P (Kentucky).

The current practice location address for Vivian Lee Rakestraw is 215 Central Ave Ste 100, Louisville, KY and can be reached out via phone at 502-852-2822 and via fax at 502-852-2819.

Location: 215 Central Ave Ste 100, Louisville, KY, 40202-1785
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Provider Profile Details
NPI Number
1316975063
Provider Name
Vivian Lee Rakestraw
Credential
Provider Entity Type
Individual
Gender
Female
Address
215 Central Ave Ste 100, Louisville, KY, 40202-1785
Phone Number
502-852-2822
Fax Number
502-852-2819
Provider Enumeration Date
06/30/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
200981170 05 IN
4778P 01 KY ARNP LICENSE
1025939 01 KY RN LICENSE
7100021840 05 KY
institution
Provider Business Practice Location Address Details
Address
215 Central Ave Ste 100
City
State
Zip
40208-1450
Phone Number
502-852-2822
Fax Number
502-852-2819
person
Provider Business Mailing Address Details
Address
215 Central Ave Ste 100
City
State
Zip
40208-1450
Phone Number
502-852-2822
Fax Number
502-852-2819
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
4778P (Kentucky)
Definition
Definition to come...
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