Provider Demographics
NPI:1750114138
Name:HUMPHREY, LABRISKA F (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LABRISKA
Middle Name:F
Last Name:HUMPHREY
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 HERMAN GREENE RD
Mailing Address - Street 2:
Mailing Address - City:OWENTON
Mailing Address - State:KY
Mailing Address - Zip Code:40359-8651
Mailing Address - Country:US
Mailing Address - Phone:502-514-2055
Mailing Address - Fax:
Practice Address - Street 1:7459 BURLINGTON PIKE
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1553
Practice Address - Country:US
Practice Address - Phone:859-578-3200
Practice Address - Fax:859-534-2627
Is Sole Proprietor?:No
Enumeration Date:2024-08-22
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4025010363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health