Provider Demographics
NPI:1881951564
Name:HUMPHREY, NORA (PT, DPT)
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:
Last Name:HUMPHREY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:NORA
Other - Middle Name:
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5304 WILD RIVER CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40229-5209
Mailing Address - Country:US
Mailing Address - Phone:859-707-3268
Mailing Address - Fax:
Practice Address - Street 1:4870 CRITTENDEN DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40209-1732
Practice Address - Country:US
Practice Address - Phone:502-361-0606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006002225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist