ETHEL DARLINE LUSTER CALDWELL (NPI# 1154375020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154375020 |
| Entity Type | Individual |
| Full Name | ETHEL DARLINE LUSTER CALDWELL |
| Other Name | ETHEL DARLINE LUSTER |
| Credential | ARNP |
| Practice Address |
870 Taylorsville Road Taylorsville KY 40071 |
| Mailing Address |
Po Box 950248 Louisville KY 40295-0248 |
| Practice Telephone | 5024778888 |
| Practice Fax Number | 5024772300 |
| Mailing Telephone | 5024895730 |
| Mailing Fax Number | 5024895753 |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2015-01-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
3004768 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | ARNP LIC# | 4768P | 01 |
| KY | 71000363800 | 05 | |
| KY | ANTHEM | 000000524808 | 01 |
| Street Address |
870 TAYLORSVILLE ROAD |
| City | TAYLORSVILLE |
| State | KY |
| Zip Code | 40071 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831482454 | Michael Jason Wells | Family Medicine | 870 Taylorsville Road, 870 Taylorsville Road, Taylorsville, KY 40071-0819 | 2011-05-16 |
| 1235326588 | Melissa Thomas | Physician Assistant | 870 Taylorsville Road, Taylorsville, KY 40071 | 2007-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609322841 | Debbie Long | Registered Nurse | 88 Spears Drive, Taylorsville, KY 40071 | 2016-08-28 |
| 1679869184 | Matthew Alan Bormann | Dentist | 501 Taylorsville Rd., Taylorsville, KY 40071 | 2011-06-22 |
| 1023325594 | Patrick Daniel Bray | Physical Therapist | 4813 Taylorsville Rd., Taylorsville, KY 40071 | 2010-09-07 |
| 1043522584 | Ernest John Kettig | Durable Medical Equipment & Medical Supplies | 206 Taylorsville Rd., Ste. A, Taylorsville, KY 40071 | 2010-07-13 |
| 1922202480 | Kristen Smotherman | Counselor | 73 East Main Street, Taylorsville, KY 40071 | 2007-06-11 |
| 1669590774 | Bg House Enterprises Inc | Physical Therapist | 4813 Taylorsville Rd, Taylorsville, KY 40071 | 2007-03-27 |
| 1346263324 | Scpg Kentucky LLC | Pharmacy | 847 Taylorsville Rd, Taylorsville, KY 40071 | 2006-07-25 |
| 1023080884 | North Central District Health Dept. | Public Health or Welfare | 88 Spears Dr, Taylorsville, KY 40071 | 2006-02-06 |
| 1801343140 | Melissa Ann Hines | Nurse Practitioner | 501 Taylorsville Rd., Taylorsville, KY 40071 | 2016-09-03 |
| 1750504767 | Becky Gay House | Physical Therapist | 4813 Taylorsville Rd, Taylorsville, KY 40071 | 2007-04-10 |
| Find all providers in zip 40071 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245890383 | Arlene R Holland | Nurse Practitioner | 3042 W Ivory Way, Taylorsville, UT 84129-6800 | 2019-06-20 |
| 1821562646 | Emily Rose Pierce | Nurse Practitioner | 1127 Chatman Ln, Taylorsville, KY 40071-9783 | 2019-01-15 |
| 1023467313 | Carrie Chestnut Herman | Nurse Practitioner | 50 Macedonia Church Rd Ste A, Taylorsville, NC 28681-8414 | 2016-06-07 |
| 1831334077 | Michelle A. Neeshan | Nurse Practitioner | 4600 S Redwood Rd # Stc048, Taylorsville, UT 84123-3145 | 2008-12-02 |
| 1104815141 | Sharon S Jamison | Nurse Practitioner | 501 Taylorsville Rd, Taylorsville, KY 40071-6766 | 2005-10-20 |
| 1932718590 | Darren L Sorensen | Nurse Practitioner | 6575 S Redwood Rd, Taylorsville, UT 84123-5688 | 2020-07-29 |
| 1285269241 | Lucretia Davis | Nurse Practitioner | 625 Taylorsville Rd, Taylorsville, KY 40071-7798 | 2020-03-10 |
| 1447891676 | Shamis Tate | Nurse Practitioner | 6575 S Redwood Rd Ste 350, Taylorsville, UT 84123-5693 | 2019-09-29 |
| 1861046773 | Brooke Nicole-hayes Massenburg | Nurse Practitioner | 31 E Main Ave, Taylorsville, NC 28681-2540 | 2019-07-29 |
| 1700303518 | Tara Tedder | Nurse Practitioner | 338 1st Ave Sw, Taylorsville, NC 28681-2402 | 2017-08-23 |
| Find all providers in TAYLORSVILLE | ||||
| City | TAYLORSVILLE |
| Zip Code | 40071 |
Please comment or provide details below to improve the information on ETHEL DARLINE LUSTER CALDWELL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.