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General NPI Number Information
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NPI Number | 1700552585
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Entity Type | Individual
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Provider Name | KASEY KINDERVATER APRN
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Gender | Female
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Dates
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Enumeration Date | 08/20/2021
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 2411 RING RD STE 114
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-5930
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Country | US
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Telephone | 270-706-1925
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Fax |
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Provider Business Mailing Address
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Address Line | 48 AZTEC CT
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-4768
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Country | US
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Telephone | 127-073-5345
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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 | 3016275
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License Number State | KY
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