Provider Demographics
NPI:1861408809
Name:ELMORE, LUANN (ARNP-C)
Entity type:Individual
Prefix:
First Name:LUANN
Middle Name:
Last Name:ELMORE
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 LIBERTY SQ
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:KY
Mailing Address - Zip Code:42539-3392
Mailing Address - Country:US
Mailing Address - Phone:606-787-5044
Mailing Address - Fax:606-787-5029
Practice Address - Street 1:511 MIDDLEBURG ST
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:KY
Practice Address - Zip Code:42539-3009
Practice Address - Country:US
Practice Address - Phone:606-787-8051
Practice Address - Fax:606-787-5545
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3004933363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care