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General NPI Number Information
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NPI Number | 1114733979
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Entity Type | Organization
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Legal Business Name | MOTHERS KEEPERS
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Dates
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Enumeration Date | 12/06/2024
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 1017 BAXTER AVE STE 1
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City | LOUISVILLE
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State | KY
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Zip | 40204-1605
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Country | US
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Telephone | 502-817-0308
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Fax |
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Provider Business Mailing Address
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Address Line | 617 SOUTHWESTERN PKWY
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City | LOUISVILLE
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State | KY
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Zip | 40211-3209
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Country | US
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Telephone | 502-817-0308
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Fax |
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Authorized Official
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Title or Position | APRN
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Name | TRANIECE DUNCAN
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Credential | APRN
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Telephone | 502-817-0308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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