Provider Demographics
NPI:1598163958
Name:EGGERS, PAIGE FAYE (BSN, RN, GRNA)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:FAYE
Last Name:EGGERS
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Gender:F
Credentials:BSN, RN, GRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:100 MALLARD CREEK RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4194
Mailing Address - Country:US
Mailing Address - Phone:502-473-2132
Mailing Address - Fax:502-459-0923
Practice Address - Street 1:100 MALLARD CREEK RD
Practice Address - Street 2:SUITE 320
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4194
Practice Address - Country:US
Practice Address - Phone:502-473-2132
Practice Address - Fax:502-459-0923
Is Sole Proprietor?:No
Enumeration Date:2014-12-16
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY1120529163W00000X
KY3009216367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse