Provider Demographics
NPI:1568601805
Name:ALLGEIER, AUTUMN (ARNP)
Entity Type:Individual
Prefix:
First Name:AUTUMN
Middle Name:
Last Name:ALLGEIER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 43905
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40253-0905
Mailing Address - Country:US
Mailing Address - Phone:502-583-4700
Mailing Address - Fax:502-583-8434
Practice Address - Street 1:13328 SHELBYVILLE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-3936
Practice Address - Country:US
Practice Address - Phone:502-583-4700
Practice Address - Fax:502-583-8434
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5921P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0562217Medicare PIN