Individual
KEVIN ALAN MARCUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3920 DUTCHMANS LN, LOUISVILLE, KY 40207-4702
(502) 259-6710
(502) 259-6704
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0328
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3016653
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300070633
—
IN
05
—
7100776840
—
KY
Enumeration date
10/07/2021
Last updated
02/13/2023
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