Provider Demographics
NPI:1679608152
Name:STROTMAN, DEBRA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:
Last Name:STROTMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 KRESGE WAY STE 236
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4640
Mailing Address - Country:US
Mailing Address - Phone:502-893-7372
Mailing Address - Fax:502-409-4715
Practice Address - Street 1:4001 KRESGE WAY STE 236
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207
Practice Address - Country:US
Practice Address - Phone:502-893-7372
Practice Address - Fax:502-409-4715
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2960P363LA2200X
KY3002960363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78004827Medicaid
KYP400038162Medicare PIN
KY78004827Medicaid
KYP13838Medicare UPIN