Provider Demographics
NPI:1225813199
Name:CROGHAN, AUBREE BURCHAM (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:AUBREE
Middle Name:BURCHAM
Last Name:CROGHAN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 CRESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-2703
Mailing Address - Country:US
Mailing Address - Phone:270-399-6412
Mailing Address - Fax:
Practice Address - Street 1:118 CRESTWOOD AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-2703
Practice Address - Country:US
Practice Address - Phone:270-399-6412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4008948363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily