Provider Demographics
NPI:1497026132
Name:GREENWELL PERKINS, KATHRYN DRU (APRN)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:DRU
Last Name:GREENWELL PERKINS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:DRU
Other - Last Name:GREENWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-1510
Mailing Address - Country:US
Mailing Address - Phone:270-827-4596
Mailing Address - Fax:270-826-2838
Practice Address - Street 1:1300 MERRITT DR STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-2788
Practice Address - Country:US
Practice Address - Phone:270-827-0064
Practice Address - Fax:270-826-3338
Is Sole Proprietor?:No
Enumeration Date:2012-01-25
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007067363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics