Individual
KATHY A NIEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1603 STEVENS AVE, LOUISVILLE, KY 40205-1087
(502) 451-5955
(502) 451-5925
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 489-5730
(502) 489-5753
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22083
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000500048
ANTHEM
KY
05
—
64220833
—
KY
Enumeration date
01/12/2006
Last updated
12/07/2020
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