Provider Demographics
NPI:1649211335
Name:HARRELL, GINGER B (ARNP MSN)
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:B
Last Name:HARRELL
Suffix:
Gender:F
Credentials:ARNP MSN
Other - Prefix:
Other - First Name:GINGER
Other - Middle Name:B
Other - Last Name:BENSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:601 S FLOYD ST
Mailing Address - Street 2:STE 804
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202
Mailing Address - Country:US
Mailing Address - Phone:502-583-0127
Mailing Address - Fax:502-583-1239
Practice Address - Street 1:601 S FLOYD ST
Practice Address - Street 2:STE 804
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202
Practice Address - Country:US
Practice Address - Phone:502-583-0127
Practice Address - Fax:502-583-1239
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1041254363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal