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General NPI Number Information
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NPI Number | 1467989533
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Entity Type | Individual
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Provider Name | KATHLEEN ANN MUNNING APN
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Gender | Female
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Dates
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Enumeration Date | 05/18/2017
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Last Update Date | 09/23/2019
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Provider Practice Location Address
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Address Line | 1950 SAINT CHARLES ST STE 4
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City | JASPER
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State | IN
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Zip | 47546-9172
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Country | US
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Telephone | 812-482-9555
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Fax | 812-482-9073
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Provider Business Mailing Address
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Address Line | PO BOX 1028
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City | JASPER
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State | IN
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Zip | 47547-1028
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Country | US
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Telephone | 812-996-8478
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71007314A
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License Number State | IN
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