Healthcare Provider Details

I. General information

NPI: 1467325738
Provider Name (Legal Business Name): HANNAH CAUDILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

799 E BRANNON RD
NICHOLASVILLE KY
40356-6038
US

IV. Provider business mailing address

109 WIND HAVEN DR STE 100
NICHOLASVILLE KY
40356-8010
US

V. Phone/Fax

Practice location:
  • Phone: 859-224-2273
  • Fax: 859-224-4675
Mailing address:
  • Phone: 859-224-2273
  • Fax: 859-224-4675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number302440
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: