Individual
KIMBERLY RECKTENWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3991 DUTCHMANS LN STE 310, LOUISVILLE, KY 40207
(502) 931-8331
(502) 348-3275
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 272-5063
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3010216
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100415290
—
KY
Enumeration date
04/01/2016
Last updated
10/27/2020
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