Provider Demographics
NPI:1558893263
Name:HIERONYMUS, LAURA LYNNE (DNP, RN, MLDE)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:LYNNE
Last Name:HIERONYMUS
Suffix:
Gender:F
Credentials:DNP, RN, MLDE
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:BERTRAM
Other - Last Name:HIERONYMUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:830 S. LIMESTONE, UNIVERSITY HEALTH SERVICES BUILDING
Mailing Address - Street 2:4TH FLOOR BARNSTABLE BROWN DIABETES CENTER
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40356-0284
Mailing Address - Country:US
Mailing Address - Phone:859-323-5407
Mailing Address - Fax:859-257-0487
Practice Address - Street 1:2195 HARRODSBURG RD STE 125
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3504
Practice Address - Country:US
Practice Address - Phone:859-218-5781
Practice Address - Fax:859-257-0659
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1041742163WD0400X
KY129917163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator