Individual
KYLE ANDREW HAVERBUSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, AGACNP-BC
Contact information
Practice address
85 N GRAND AVE, FORT THOMAS, KY 41075-4027
(859) 344-1600
(859) 344-0091
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 344-1600
(859) 344-0091
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3018923
KY
363LA2100X
Acute Care Nurse Practitioner
0031082
OH
Other
Enumeration date
07/03/2023
Last updated
03/18/2024
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