Provider Demographics
NPI:1265579700
Name:PERMIN, CATHERINE (APRN, FNP, PMHNP)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:PERMIN
Suffix:
Gender:F
Credentials:APRN, FNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 QUAIL RUN RD
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-1511
Mailing Address - Country:US
Mailing Address - Phone:859-321-3671
Mailing Address - Fax:
Practice Address - Street 1:444 QUAIL RUN RD
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-1511
Practice Address - Country:US
Practice Address - Phone:859-321-3671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005098363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100004300Medicaid
KY7100004300Medicaid