Provider Demographics
NPI:1942289608
Name:VANLAHR, MARINETTA (ARNP, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:MARINETTA
Middle Name:
Last Name:VANLAHR
Suffix:
Gender:F
Credentials:ARNP, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 OLD HWY 60
Mailing Address - Street 2:
Mailing Address - City:HARDINSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40143
Mailing Address - Country:US
Mailing Address - Phone:270-580-2250
Mailing Address - Fax:270-580-2253
Practice Address - Street 1:107 OLD HIGHWAY 60
Practice Address - Street 2:
Practice Address - City:HARDINSBURG
Practice Address - State:KY
Practice Address - Zip Code:40143-2501
Practice Address - Country:US
Practice Address - Phone:270-580-2250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2017-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2372P363LF0000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78-002094Medicaid
KYS44537Medicare UPIN
KY1098103Medicare ID - Type Unspecified