Individual
MR. DAVID WATHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
7926 PRESTON HWY STE 106, LOUISVILLE, KY 40219-3848
(502) 964-4357
(502) 966-5948
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
3017105
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3017105
LICENSE
KY
Enumeration date
01/23/2022
Last updated
01/31/2025
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