Healthcare Provider Details

I. General information

NPI: 1679017958
Provider Name (Legal Business Name): KATIE NORRIS MSN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2016
Last Update Date: 02/13/2023
Certification Date: 10/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1939 GOLDSMITH LN 143
LOUISVILLE KY
40218-2006
US

IV. Provider business mailing address

3813 POPLAR LEVEL RD
LOUISVILLE KY
40213-1429
US

V. Phone/Fax

Practice location:
  • Phone: 855-591-0092
  • Fax:
Mailing address:
  • Phone: 502-255-1925
  • Fax: 518-213-4691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3010925
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: