Healthcare Provider Details

I. General information

NPI: 1063259851
Provider Name (Legal Business Name): KATELYNN MICHELLE ROGERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATELYNN MICHELLE TAULBEE

II. Dates (important events)

Enumeration Date: 07/10/2024
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 S MAIN ST
WINCHESTER KY
40391-2601
US

IV. Provider business mailing address

32 HIAWATHA TRL
WINCHESTER KY
40391-2244
US

V. Phone/Fax

Practice location:
  • Phone: 859-345-1331
  • Fax: 859-762-1695
Mailing address:
  • Phone: 859-595-0975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4022869
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: