Individual
KYLE S FOUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
501 S MADISON ST STE 105, BLOOMINGTON, IN 47403-2452
(812) 929-2193
(888) 789-8394
Mailing address
5010 N STONE MILL RD STE B, BLOOMINGTON, IN 47408-9320
(812) 929-7956
(888) 789-8394
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
28248377A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71014458A
IN
Other
Enumeration date
09/29/2023
Last updated
05/15/2024
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