Provider Demographics
NPI:1386274215
Name:FURGE, KATHRYN (FNP-B)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:
Last Name:FURGE
Suffix:
Gender:F
Credentials:FNP-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HOSPITAL LN
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46122-1989
Mailing Address - Country:US
Mailing Address - Phone:971-520-5510
Mailing Address - Fax:317-386-5539
Practice Address - Street 1:100 HOSPITAL LN STE 1340
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-1989
Practice Address - Country:US
Practice Address - Phone:317-520-5510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-20
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28202459A163W00000X
IN71011291A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN71011291AOtherSTATE OF INDIANA BOARD OF NURSING APRN LICENSE
IN28202459AOtherSTATE OF INDIANA - BOARD OF NURSING