Provider Demographics
NPI:1528017241
Name:KNUEVEN, JUDITH A (ARNP)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:A
Last Name:KNUEVEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2380 GRANDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FT MITCHELL
Mailing Address - State:KY
Mailing Address - Zip Code:41017-1633
Mailing Address - Country:US
Mailing Address - Phone:859-331-7234
Mailing Address - Fax:859-578-7986
Practice Address - Street 1:2380 GRANDVIEW DR
Practice Address - Street 2:
Practice Address - City:FT MITCHELL
Practice Address - State:KY
Practice Address - Zip Code:41017-1633
Practice Address - Country:US
Practice Address - Phone:859-331-7234
Practice Address - Fax:859-578-7986
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1044955163WP0809X
KY2004S363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Not Answered363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY065807OtherVALUE OPTIONS
KY1200886OtherCHA HEALTH
KY0000000294182OtherANTHEM
KY9134156OtherPHCS