Basic Information
| Provider Information | |||||||||
| NPI: | 1790709236 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TUDOR | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2700 STANLEY GAULT PKWY STE 129 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402235176 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5024896613 | ||||||||
| FaxNumber: | 5024895751 | ||||||||
| Practice Location | |||||||||
| Address1: | 3900 KRESGE WAY | ||||||||
| Address2: | SUITE 51 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 40207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5022595955 | ||||||||
| FaxNumber: | 5022595953 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 12/04/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 3004491 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 200893710 | 01 | KY | ANTHEM INDIANA MEDICAID- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY | OTHER | 000023035L | 01 | KY | HUMANA- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY | OTHER | 78016110 | 01 | KY | MEDICAID KY- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY | OTHER | P00706053 | 01 | KY | RAILROAD MEDICARE- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY | OTHER | 102637 | 01 | KY | SIHO- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY | OTHER | 200893710 | 01 | KY | MD WISE- NNIKY | OTHER | 200893710 | 05 | KY | MEDICAID | 200893710 | 01 | KY | HEALTHY INDIANA PLAN- NNIKY | OTHER | 200893710 | 01 | KY | MANAGED HEALTH SERVICES- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY | OTHER | 2170111 | 01 | KY | CIGNA- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY | OTHER | 50022597 | 01 | KY | PASSPORT- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY | OTHER | 000000507656 | 01 | ANTHEM | OTHER | 00533107 | 01 | KY | ANTHEM- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY | OTHER | 00533107 | 01 | KY | MEDICARE- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY | OTHER | 3697392000 | 01 | KY | PASSPORT ADVANTAGE- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY | OTHER |