Healthcare Provider Details

I. General information

NPI: 1184557811
Provider Name (Legal Business Name): KATIE MILLS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 OLD HARRODS CREEK RD
LOUISVILLE KY
40223-2553
US

IV. Provider business mailing address

191 MCGOWAN AVE
BARDSTOWN KY
40004-1785
US

V. Phone/Fax

Practice location:
  • Phone: 502-263-3457
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4049164
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: