Healthcare Provider Details

I. General information

NPI: 1497026132
Provider Name (Legal Business Name): KATHRYN DRU GREENWELL PERKINS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN DRU GREENWELL

II. Dates (important events)

Enumeration Date: 01/25/2012
Last Update Date: 10/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 MERRITT DR STE 100
HENDERSON KY
42420-2788
US

IV. Provider business mailing address

PO BOX 1510
EVANSVILLE IN
47706-1510
US

V. Phone/Fax

Practice location:
  • Phone: 270-827-0064
  • Fax: 270-826-3338
Mailing address:
  • Phone: 270-827-4596
  • Fax: 270-826-2838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number3007067
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: