Provider Demographics
NPI:1083469274
Name:PATHE PSYCHIATRY, LLC
Entity type:Organization
Organization Name:PATHE PSYCHIATRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PERCEFULL
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-C, PMHNP-BC
Authorized Official - Phone:270-486-1479
Mailing Address - Street 1:575 D W MEREDITH RD
Mailing Address - Street 2:
Mailing Address - City:MUNFORDVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42765-9315
Mailing Address - Country:US
Mailing Address - Phone:270-486-1479
Mailing Address - Fax:
Practice Address - Street 1:2626 RING RD
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-9118
Practice Address - Country:US
Practice Address - Phone:270-486-1479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty