Provider Demographics
NPI:1306122759
Name:MUELLER, CASSANDRA KATHRYN (APRN)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:KATHRYN
Last Name:MUELLER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:KATHRYN
Other - Last Name:NALLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:9510 ORMSBY STATION RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4082
Mailing Address - Country:US
Mailing Address - Phone:502-327-9100
Mailing Address - Fax:855-632-8329
Practice Address - Street 1:9510 ORMSBY STATION RD STE 100
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-4082
Practice Address - Country:US
Practice Address - Phone:502-327-9100
Practice Address - Fax:855-632-8329
Is Sole Proprietor?:No
Enumeration Date:2011-10-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007190363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
12304881OtherCAQH