Healthcare Provider Details

I. General information

NPI: 1528017241
Provider Name (Legal Business Name): JUDITH A. KNUEVEN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2380 GRANDVIEW DR
FT MITCHELL KY
41017-1633
US

IV. Provider business mailing address

2380 GRANDVIEW DR
FT MITCHELL KY
41017-1633
US

V. Phone/Fax

Practice location:
  • Phone: 859-331-7234
  • Fax: 859-578-7986
Mailing address:
  • Phone: 859-331-7234
  • Fax: 859-578-7986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number1044955
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2004S
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: