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Individual

MRS. KATHLEEN JANE HALVERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
826 N 6TH ST, MONTICELLO, IN 47960-1752
(574) 583-3333
(574) 583-2896
Mailing address
826 N 6TH ST, MONTICELLO, IN 47960-1752
(574) 583-3333
(574) 583-2896

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71000299A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000335832
ANTHEM BLUE CROSS
01
1540739
UNITED MINEWORKERS
05
200121420
IN
01
500002653
RAILROAD MEDICARE
01
5531418
AETNA
Enumeration date
05/24/2005
Last updated
09/20/2011
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