Healthcare Provider Details

I. General information

NPI: 1902955313
Provider Name (Legal Business Name): LAURA S MUELLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 11/13/2020
Certification Date: 11/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2327 LIME KILN LN STE A
LOUISVILLE KY
40222-3422
US

IV. Provider business mailing address

1008 OXMOOR WOODS PKWY
LOUISVILLE KY
40222-5582
US

V. Phone/Fax

Practice location:
  • Phone: 502-339-2818
  • Fax: 502-339-2820
Mailing address:
  • Phone: 502-468-9812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number28839
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number28839
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: