Individual
KATHLEEN E VIDOUREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
816 RUDOLPH WAY, GREENDALE, IN 47025-8312
(812) 537-1668
Mailing address
816 RUDOLPH WAY, GREENDALE, IN 47025-8312
(812) 537-1668
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27067793A
IN
Other
Enumeration date
06/16/2022
Last updated
06/16/2022
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