Keathley, Kathryn Moore

Keathley, Kathryn Moore is an individual health care provider with primary practice located at 1640 Flossie Dr , Greendale IN 47025-8424. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Keathley, Kathryn Moore can be contacted via phone (812) 496-3290.

Contact Information

Primary practice address
1640 Flossie Dr Greendale IN 47025-8424
Phone: (812) 496-3290
Fax: (812) 537-0400
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3009737 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 3009737 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71007956A Indiana

Profile Details

NPI number 1649642406
LBN Legal business name Keathley, Kathryn Moore
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2015
Last updated Apr 21st, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649642406 NPPES
Kentucky MEDICAID 7100379650

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