Provider Demographics
NPI:1629812458
Name:HYLAND, MAURA DUFFY (NP)
Entity type:Individual
Prefix:
First Name:MAURA
Middle Name:DUFFY
Last Name:HYLAND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MAURA
Other - Middle Name:ELIZABETH
Other - Last Name:DUFFY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:602 TURNSTILE TRCE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-3454
Mailing Address - Country:US
Mailing Address - Phone:502-938-5227
Mailing Address - Fax:
Practice Address - Street 1:602 TURNSTILE TRCE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-3454
Practice Address - Country:US
Practice Address - Phone:502-938-5227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4017239363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily