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NPI Code Detail

MEDICARE: KYLE S FOUCH APRN

MEDICARE: KYLE S FOUCH APRN
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
1163WP0808XPsychiatric/Mental Health Registered Nurse28248377AIN
2363LP0808XPsychiatric/Mental Health Nurse Practitioner71014458AIN

General Provider Information

NPI Number : 1417737396
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLE S FOUCH APRN
Provider Business Mailing Address
First Line : 5010 N STONE MILL RD STE B
Second Line :
City : BLOOMINGTON
State : IN
Zip : 47408-9320
Country : US
Telephone Number : 812-929-7956
Fax Number : 888-789-8394
Provider Business Practice Location Address
First Line : 501 S MADISON ST STE 105
Second Line :
City : BLOOMINGTON
State : IN
Zip : 47403-2452
Country : US
Telephone Number : 812-929-2193
Fax Number : 888-789-8394
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2023
Last Update Date : 05/15/2024

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Directions to “ KYLE S FOUCH APRN” Practice Location

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