Provider Demographics
NPI:1497393011
Name:JOHNS, KATHERINE ROSE ASH (APRN)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ROSE ASH
Last Name:JOHNS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:ROSE
Other - Last Name:ASH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:17107 GREEN CREST LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-3216
Mailing Address - Country:US
Mailing Address - Phone:502-751-5035
Mailing Address - Fax:
Practice Address - Street 1:912 LILY CREEK RD STE 200
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-2815
Practice Address - Country:US
Practice Address - Phone:502-822-3659
Practice Address - Fax:502-709-4637
Is Sole Proprietor?:No
Enumeration Date:2019-12-13
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3013849363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily