Most Relevant Information
Provider Data
| NPI Number: | 1003437880 |
| Provider Name: | KATHRYN NICOLE LOGAN PMHNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | 1-134637 |
Most Important Dates
| Enumeration Date: | 05/02/2020 |
| Last Updated: | 01/11/2023 |
Provider Practice Location
4371 NARROW LANE RD STE 205
MONTGOMERY
AL
361162975
Practice Location Phone/Fax
| Phone: | 3347477780 |
| Fax: | 3347477790 |
Provider Mailing Location
301 BROWN SPRINGS RD
MONTGOMERY
AL
361177005
Provider Mailing Phone/Fax
| Phone: | 3347474159 |
| Fax: |