Individual
KRISTIN M KOETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4123 DUTCHMANS LN STE 101, LOUISVILLE, KY 40207-4718
(502) 899-6782
(502) 899-6783
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3003247
KY
363L00000X
Nurse Practitioner
3247P
KY
363L00000X
Nurse Practitioner
71001123A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000541708
ANTHEM
KY
01
—
1202794
CHA
KY
01
—
KY950P
SIHO
KY
01
—
P00293222
MEDICARE RAILROAD - KY
KY
Enumeration date
04/19/2006
Last updated
11/13/2024
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