Healthcare Provider Details

I. General information

NPI: 1477268746
Provider Name (Legal Business Name): KATHRYN TAYLOR AYRES APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2023
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2609 NEW HARTFORD RD STE 3
OWENSBORO KY
42303-1394
US

IV. Provider business mailing address

PO BOX 1099
OWENSBORO KY
42302-1099
US

V. Phone/Fax

Practice location:
  • Phone: 812-476-7111
  • Fax: 812-476-7117
Mailing address:
  • Phone: 423-339-2320
  • Fax: 423-339-2321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3018832
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71013555A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3018832
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: