Provider Demographics
NPI:1063080166
Name:HERRELL, KAREN (APRN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:HERRELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 AUDUBON PLAZA DR STE 150
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40217-1362
Mailing Address - Country:US
Mailing Address - Phone:502-636-4968
Mailing Address - Fax:502-636-4953
Practice Address - Street 1:3 AUDUBON PLAZA DR STE 150
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1362
Practice Address - Country:US
Practice Address - Phone:502-636-4968
Practice Address - Fax:502-636-4953
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3016223363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily