Provider Demographics
NPI:1508120502
Name:CABLE, TERRY L (APRN)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:L
Last Name:CABLE
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:10401 LINN STATION RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-3842
Mailing Address - Country:US
Mailing Address - Phone:502-589-8600
Mailing Address - Fax:888-700-0187
Practice Address - Street 1:600 S PRESTON ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1716
Practice Address - Country:US
Practice Address - Phone:270-319-2826
Practice Address - Fax:888-700-0187
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2024-05-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY3007482363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100263320Medicaid