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Individual

MS. CATHERINE ANN MUTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
4123 DUTCHMANS LN STE 102, LOUISVILLE, KY 40207-4718
(502) 559-1670
(502) 559-1679
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3003861
KY
363LF0000X
Family Nurse Practitioner
71001861A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000001087569
ANTHEM
KY
01
019300
SIHO
KY
05
200412070
IN
05
300002914
IN
01
50128159
PASSPORT
KY
05
78008927
KY
01
K087131
MEDICARE
KY
Enumeration date
10/04/2005
Last updated
04/11/2024
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