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Individual

DIANE KOLENICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
A.R.N.P.

Contact information

Practice address
619 OLD SYMSONIA RD, BENTON, KY 42025-5094
(270) 527-2411
(270) 527-8734
Mailing address
619 OLD SYMSONIA RD, BENTON, KY 42025-5094
(270) 527-2411
(270) 527-8734

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209006254
IL
363LF0000X
Family Nurse Practitioner
Primary
4570P
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
766802
HEALTHLINK
KY
01
P00296264
RAILROAD MEDICARE
KY
Enumeration date
05/16/2006
Last updated
03/01/2016
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