Provider Demographics
NPI:1700558095
Name:MULLER, KATY NICOLE (APRN,FNP-C)
Entity Type:Individual
Prefix:
First Name:KATY
Middle Name:NICOLE
Last Name:MULLER
Suffix:
Gender:F
Credentials:APRN,FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 LANIE DR
Mailing Address - Street 2:
Mailing Address - City:KEVIL
Mailing Address - State:KY
Mailing Address - Zip Code:42053-9341
Mailing Address - Country:US
Mailing Address - Phone:270-217-3777
Mailing Address - Fax:
Practice Address - Street 1:2603 KENTUCKY AVE STE 102
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-3815
Practice Address - Country:US
Practice Address - Phone:270-442-3539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3016775363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily