Provider Demographics
NPI:1326311168
Name:NASER, AUDREY YVONNE (APRN MENTAL HEALTH)
Entity Type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:YVONNE
Last Name:NASER
Suffix:
Gender:F
Credentials:APRN MENTAL HEALTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 TRAIL RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-6402
Mailing Address - Country:US
Mailing Address - Phone:502-426-1419
Mailing Address - Fax:
Practice Address - Street 1:3303 TRAIL RIDGE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-6402
Practice Address - Country:US
Practice Address - Phone:502-426-1419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007239363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health