Healthcare Provider Details

I. General information

NPI: 1760956759
Provider Name (Legal Business Name): NICOLETTE KUZMAN M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLETTE ISON

II. Dates (important events)

Enumeration Date: 01/14/2019
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 SKYLINE DR
GEORGETOWN KY
40324-8790
US

IV. Provider business mailing address

202 SKYLINE DR
GEORGETOWN KY
40324-8790
US

V. Phone/Fax

Practice location:
  • Phone: 606-356-9173
  • Fax:
Mailing address:
  • Phone: 606-356-9173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number247817
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: