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General NPI Number Information
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NPI Number | 1760864169
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Entity Type | Individual
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Provider Name | KASEY JEAN HOLLENBACH
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Gender | Female
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Dates
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Enumeration Date | 06/22/2015
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 1205 AUDUBON PKWY
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City | LOUISVILLE
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State | KY
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Zip | 40213-1236
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Country | US
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Telephone | 502-439-2617
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 SPRING ST STE B
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-2930
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Country | US
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Telephone |
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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 | 1128381
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71007701A
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License Number State | IN
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