Individual
NATHAN JAMES FORKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1900 BLUEGRASS AVE STE 103, LOUISVILLE, KY 40215-1144
(502) 367-4500
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 367-4500
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
11014219
FL
363LF0000X
Family Nurse Practitioner
Primary
3013399
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100608320
—
KY
Enumeration date
06/11/2019
Last updated
03/02/2023
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