Provider Demographics
NPI:1336143288
Name:OBERT, LOIS (ARNP)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:
Last Name:OBERT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LOIS
Other - Middle Name:
Other - Last Name:OBERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP
Mailing Address - Street 1:10505 COLONEL HANCOCK DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40291-4081
Mailing Address - Country:US
Mailing Address - Phone:502-231-5339
Mailing Address - Fax:502-231-5339
Practice Address - Street 1:10505 COLONEL HANCOCK DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291
Practice Address - Country:US
Practice Address - Phone:502-231-5339
Practice Address - Fax:502-231-5339
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003433A163WC1600X, 363LF0000X
KY3364P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0614206Medicare ID - Type Unspecified
KYQ06725Medicare UPIN