Healthcare Provider Details

I. General information

NPI: 1679877427
Provider Name (Legal Business Name): KATIE MCPHERSON CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2011
Last Update Date: 05/21/2020
Certification Date: 05/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 ALEXANDRIA PIKE
HIGHLAND HEIGHTS KY
41076-1530
US

IV. Provider business mailing address

7691 5 MILE RD SUITE 10
CINCINNATI OH
45230-4348
US

V. Phone/Fax

Practice location:
  • Phone: 859-781-4111
  • Fax: 859-441-5214
Mailing address:
  • Phone: 513-624-7246
  • Fax: 513-624-6900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA12017-NP
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3006516
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: