Provider Demographics
NPI:1679017958
Name:NORRIS, KATIE (MSN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:NORRIS
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3813 POPLAR LEVEL RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40213-1429
Mailing Address - Country:US
Mailing Address - Phone:502-255-1925
Mailing Address - Fax:518-213-4691
Practice Address - Street 1:1939 GOLDSMITH LN
Practice Address - Street 2:143
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-2006
Practice Address - Country:US
Practice Address - Phone:855-591-0092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-06
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010925363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health