Healthcare Provider Details

I. General information

NPI: 1811826407
Provider Name (Legal Business Name): CIERRA CONNELLEY APRN-CNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 BERRY RD
CLEARFIELD KY
40313-9646
US

IV. Provider business mailing address

163 BERRY RD
CLEARFIELD KY
40313-9646
US

V. Phone/Fax

Practice location:
  • Phone: 606-207-8986
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4057352
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: