Provider Demographics
NPI:1871911248
Name:STORTROEN, BARBARA ANN (LPN)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:STORTROEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:B
Other - Middle Name:ANN
Other - Last Name:HAWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3003 TREE LN
Mailing Address - Street 2:APT D18
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-3073
Mailing Address - Country:US
Mailing Address - Phone:502-807-2508
Mailing Address - Fax:
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:502-583-3951
Practice Address - Fax:502-581-9234
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2040829164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse