Provider Demographics
NPI:1043210537
Name:MCELROY, LAURA A (APRN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:MCELROY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:A
Other - Last Name:HOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9800 SHELBYVILLE RD
Mailing Address - Street 2:SUITE #220
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2992
Mailing Address - Country:US
Mailing Address - Phone:502-429-8585
Mailing Address - Fax:855-656-7325
Practice Address - Street 1:9800 SHELBYVILLE RD
Practice Address - Street 2:SUITE #220
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-2992
Practice Address - Country:US
Practice Address - Phone:502-429-8585
Practice Address - Fax:502-429-6157
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000851A363L00000X
KY3002321363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78003167Medicaid
KY1114087OtherPASSPORT
IN200244290Medicaid
KY78003167Medicaid
KYP47737Medicare UPIN
KY0682410Medicare ID - Type UnspecifiedPROVIDER NUMBER
IN181540HMedicare ID - Type UnspecifiedPROVIDER NUMBER