Provider Demographics
NPI:1346447570
Name:MACALUSO, SARA KATHY (APRN)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:KATHY
Last Name:MACALUSO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:KATHY
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:315 EAST BROADWAY
Mailing Address - Street 2:EMPLOYEE HEALTH, NORTON PAVILION
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202
Mailing Address - Country:US
Mailing Address - Phone:502-629-8920
Mailing Address - Fax:502-629-7026
Practice Address - Street 1:315 EAST BROADWAY
Practice Address - Street 2:EMPLOYEE HEALTH, NORTON PAVILION
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202
Practice Address - Country:US
Practice Address - Phone:502-629-8920
Practice Address - Fax:502-629-7026
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4464P363LF0000X
KY3004464363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q31766Medicare UPIN