MEDICARE: KATIE ROCOVICH 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
1	363LF0000X	Family Nurse Practitioner	71017631A	IN
2	363LF0000X	Family Nurse Practitioner	3015307	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3015307	OTHER	KY	KY LICENSE
2	71017631A	OTHER	IN	IN LICENSE

General Provider Information

NPI Number	:	1457959900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE ROCOVICH APRN

Provider Business Mailing Address
First Line	:	PO BOX 909
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40201-0909
Country	:	US
Telephone Number	:	502-588-0328
Fax Number	:

Provider Business Practice Location Address
First Line	:	3558 E 10TH ST
Second Line	:
City	:	JEFFERSONVILLE
State	:	IN
Zip	:	47130-9315
Country	:	US
Telephone Number	:	812-562-4699
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2020
Last Update Date	:	06/09/2026

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