MEDICARE: KATELYN KUSZMAUL 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	163W00000X	Registered Nurse	282334178	IN
2	363L00000X	Nurse Practitioner	71018118A	IN

General Provider Information

NPI Number	:	1780520999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN KUSZMAUL FNP

Provider Business Mailing Address
First Line	:	3218 DAUGHERTY DR
Second Line	:
City	:	LAFAYETTE
State	:	IN
Zip	:	47909-3997
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3218 DAUGHERTY DR
Second Line	:
City	:	LAFAYETTE
State	:	IN
Zip	:	47909-3997
Country	:	US
Telephone Number	:	765-502-4190
Fax Number	:

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

Provider Enumeration Date	:	04/28/2026
Last Update Date	:	05/12/2026

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