Healthcare Provider Details

I. General information

NPI: 1487252532
Provider Name (Legal Business Name): KATIE NORRIS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2020
Last Update Date: 01/17/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6540 OUTER LOOP
LOUISVILLE KY
40228
US

IV. Provider business mailing address

6540 OUTER LOOP
LOUISVILLE KY
40228
US

V. Phone/Fax

Practice location:
  • Phone: 502-255-1925
  • Fax: 518-213-4671
Mailing address:
  • Phone: 502-255-1925
  • Fax: 518-213-4671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KATIE NORRIS
Title or Position: OWNER/APRN
Credential:
Phone: 502-255-1925