Individual
KATHERINE MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3900 KRESGE WAY STE 51, LOUISVILLE, KY 40207-4683
(502) 259-5955
Mailing address
5200 COMMERCE CROSSINGS DR FL 3, LOUISVILLE, KY 40229-2182
(502) 253-4924
(502) 489-5750
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3013167
KY
363LF0000X
Family Nurse Practitioner
Primary
3013167
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
KY
Enumeration date
11/14/2018
Last updated
04/04/2022
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