Provider Demographics
NPI:1801623327
Name:ROURKE, ELIZABETH ANN (LPN)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:ROURKE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8906 ZABEL WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40291-1553
Mailing Address - Country:US
Mailing Address - Phone:502-410-8830
Mailing Address - Fax:
Practice Address - Street 1:8906 ZABEL WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-1553
Practice Address - Country:US
Practice Address - Phone:502-410-8830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2045862164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse