MEDICARE: KATHRYN ARMSTRONG FNP

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	363LF0000X	Family Nurse Practitioner	R897736	MS
2	363LF0000X	Family Nurse Practitioner	0024172925	AL

General Provider Information

NPI Number	:	1700255916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN ARMSTRONG FNP

Provider Business Mailing Address
First Line	:	106 W MAIN ST
Second Line	:	P O BOX 470
City	:	LOUISVILLE
State	:	MS
Zip	:	39339-2620
Country	:	US
Telephone Number	:	662-446-1972
Fax Number	:	662-446-1039

Provider Business Practice Location Address
First Line	:	106 W MAIN ST
Second Line	:
City	:	LOUISVILLE
State	:	MS
Zip	:	39339-2620
Country	:	US
Telephone Number	:	662-446-1972
Fax Number	:	662-446-1039

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

Provider Enumeration Date	:	09/17/2015
Last Update Date	:	04/12/2016

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