Healthcare Provider Details

I. General information

NPI: 1093353054
Provider Name (Legal Business Name): LATCHED LOUISVILLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2019
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 EVERGREEN RD # 108
LOUISVILLE KY
40243-1010
US

IV. Provider business mailing address

350 EVERGREEN RD # 108
LOUISVILLE KY
40243-1010
US

V. Phone/Fax

Practice location:
  • Phone: 502-777-0203
  • Fax:
Mailing address:
  • Phone: 502-777-0203
  • Fax: 502-917-2159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TEREZA J PEERCY
Title or Position: OWNER
Credential: APRN, IBCLC
Phone: 502-777-0203