Individual
DR. KATHERINE HARTIGAN JETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1031 NEW MOODY LN, SUITE 301, LA GRANGE, KY 40031-9189
(502) 225-5520
(502) 225-5522
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 253-1035
(502) 253-1037
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
43574
KY
208000000X
Pediatrics Physician
43574
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50029750
PASSPORT
KY
05
—
7100124040
—
KY
Enumeration date
04/02/2007
Last updated
12/07/2020
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