Provider Demographics
NPI:1083886907
Name:COLLIER, CATHY ELIZABETH (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:ELIZABETH
Last Name:COLLIER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E LIBERTY ST STE 800
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1428
Mailing Address - Country:US
Mailing Address - Phone:502-367-4500
Mailing Address - Fax:502-368-8139
Practice Address - Street 1:1900 BLUEGRASS AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40215-1144
Practice Address - Country:US
Practice Address - Phone:502-367-4500
Practice Address - Fax:502-368-8139
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005441363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201032960Medicaid
KY7100057910Medicaid
KYP00983036Medicare PIN
KY7100057910Medicaid