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NPI Code Detail

MEDICARE: KATHLEEN TIERNEY LANHAM MSN, APRN, NP-C

MEDICARE: KATHLEEN TIERNEY LANHAM MSN, APRN, NP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner3013063KY
2363LP2300XPrimary Care Nurse Practitioner3013063KY
3363LF0000XFamily Nurse Practitioner3013063KY

General Provider Information

NPI Number : 1295388221
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN TIERNEY LANHAM MSN, APRN, NP-C
Provider Business Mailing Address
First Line : PO BOX 3276
Second Line :
City : EVANSVILLE
State : IN
Zip : 47731-3276
Country : US
Telephone Number : 812-473-0181
Fax Number : 812-473-5822
Provider Business Practice Location Address
First Line : 2120 PAYNE ST
Second Line :
City : LOUISVILLE
State : KY
Zip : 40206-2012
Country : US
Telephone Number : 502-552-8597
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2019
Last Update Date : 06/01/2026

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