Provider Demographics
NPI:1366697526
Name:VOLPERT, ELISABETH MARIE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:ELISABETH
Middle Name:MARIE
Last Name:VOLPERT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:ELISABETH
Other - Middle Name:
Other - Last Name:BENGERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:501 E BROADWAY
Mailing Address - Street 2:STE 220
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1785
Mailing Address - Country:US
Mailing Address - Phone:502-589-4856
Mailing Address - Fax:502-589-5093
Practice Address - Street 1:401 E CHESTNUT ST
Practice Address - Street 2:STE. 370
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-5700
Practice Address - Country:US
Practice Address - Phone:502-562-6510
Practice Address - Fax:502-562-6515
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5831P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY106198OtherSIHO
000000647607OtherANTHEM
IN200972400Medicaid
KY50027325OtherPASSPORT HEALTH PLAN
KY7100097860Medicaid
KY000000626497OtherANTHEM
KY000000626497OtherANTHEM
000000647607OtherANTHEM