Basic Information
| Provider Information | |||||||||
| NPI: | 1750847661 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUST | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | JOELLEN | ||||||||
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| Credential: | DNP, APRN, NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4801 OLYMPIA PARK PLZ STE 3000 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402410001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5022725253 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7926 PRESTON HWY STE 106 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402193848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5029644357 | ||||||||
| FaxNumber: | 5029665948 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2019 | ||||||||
| LastUpdateDate: | 10/14/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/14/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 3013126 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.