Provider Demographics
NPI:1396781431
Name:GARTH, KATY E (ARNP)
Entity type:Individual
Prefix:MRS
First Name:KATY
Middle Name:E
Last Name:GARTH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MISS
Other - First Name:KATY
Other - Middle Name:
Other - Last Name:PEEBLES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:300 SOUTH 8TH ST
Mailing Address - Street 2:STE 301E
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2400
Mailing Address - Country:US
Mailing Address - Phone:270-762-1566
Mailing Address - Fax:270-762-1584
Practice Address - Street 1:300 SOUTH 8TH ST
Practice Address - Street 2:STE 301E
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2400
Practice Address - Country:US
Practice Address - Phone:270-762-1566
Practice Address - Fax:270-762-2858
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3001918363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7800262300Medicaid
KY000000370089OtherBCBS KY
S89807Medicare UPIN
KY0970201Medicare ID - Type Unspecified