MEDICARE: KATHLEEN KLEIER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174H00000X	Health Educator	K02-701-112	KY

General Provider Information

NPI Number	:	1336452143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN KLEIER

Provider Business Mailing Address
First Line	:	12500 GRAND OAK CT
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40299-4136
Country	:	US
Telephone Number	:	502-802-4452
Fax Number	:

Provider Business Practice Location Address
First Line	:	12500 GRAND OAK CT
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40299-4136
Country	:	US
Telephone Number	:	502-802-4452
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2010
Last Update Date	:	07/21/2010

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