# KATHLEEN ANN DIVELY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1639137763
- **Gender:** F
- **Credential:** ARNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 2743P | KY | Yes |

## Other

- **Enumeration date:** 05/01/2006
- **Last updated:** 08/17/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 64314107 | — | KY |
| 05 | — | 7100029980 | — | KY |