Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 3014386 | KY |
NPI | 1790319689 |
---|---|
Provider Name | Katherine Marie Burch |
First Address | Nashville, TN 37214-3108 |
Second Address | Middletown, KY 40243-1530 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2020 |
Last Update Date | 28/02/2020 |