Healthcare Provider Details

I. General information

NPI: 1851945257
Provider Name (Legal Business Name): KATIE HARE KUZMA DNP, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2019
Last Update Date: 01/10/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2724 NASHVILLE RD
BOWLING GREEN KY
42101-4000
US

IV. Provider business mailing address

PO BOX 90007
BOWLING GREEN KY
42102-9007
US

V. Phone/Fax

Practice location:
  • Phone: 270-393-2753
  • Fax: 270-393-2738
Mailing address:
  • Phone: 270-781-5111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3013633
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: