Individual
KATHRYN MOORE KEATHLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1640 FLOSSIE DR, GREENDALE, IN 47025-8424
(812) 496-3290
(812) 537-0400
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 757-0434
(859) 441-0906
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3009737
KY
363L00000X
Nurse Practitioner
71007956A
IN
363LF0000X
Family Nurse Practitioner
3009737
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100379650
—
KY
Enumeration date
10/20/2015
Last updated
04/21/2020
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