MEDICARE: KATHLEEN AMBER KEARNEY NAYLOR D.O.

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	207QS0010X	Sports Medicine (Family Medicine) Physician	05130	KY
2	207QS0010X	Sports Medicine (Family Medicine) Physician	02008786A	IN
3	207Q00000X	Family Medicine Physician	05130	KY
4	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1982139085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN AMBER KEARNEY NAYLOR D.O.

Provider Business Mailing Address
First Line	:	5200 COMMERCE CROSSINGS DR FL 3
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40229-2182
Country	:	US
Telephone Number	:	502-253-4924
Fax Number	:	502-489-5750

Provider Business Practice Location Address
First Line	:	3605 FERN VALLEY RD STE 320
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40219-1916
Country	:	US
Telephone Number	:	440-585-6553
Fax Number	:

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

Provider Enumeration Date	:	04/26/2017
Last Update Date	:	01/06/2026

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