KATHLEEN B BERGHAUSEN


Address: 4112 Fern Valley Rod, Louisville, KY 40219
Phone: 5023092675

KATHLEEN B BERGHAUSEN (NPI# 1255948154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1255948154
Entity Type Individual
Full Name KATHLEEN B BERGHAUSEN
Credential NP
Practice Address 4112 Fern Valley Rod
Louisville
KY 40219
Mailing Address 2414 Tavener Dr
Louisville
KY 40242-4034
Practice Telephone 5023092675
Mailing Telephone 5025580916
Enumeration Date 2020-09-25
Last Update Date 2020-09-25
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
3015109 KY Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
KY 3015109 05

Office Location

Street Address 4112 FERN VALLEY ROD
City LOUISVILLE
State KY
Zip Code 40219

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1942748447 Melissa Freeman Emanuele Speech-Language Pathologist 1550 Raydale Drive, Lousville, KY 40219 2017-02-03
1083014013 Christopher Maxey Specialist/Technologist Fern Valley Rd, Louisville, KY 40219 2014-08-27
1679985949 Antwan Turner Case Manager/Care Coordinator 5523 Saxon Blvd, Louisville, KY 40219 2014-05-21
1386055168 Kelly Larson Case Manager/Care Coordinator 6809 Bebe Ct., Louisville, KY 40219 2014-05-14
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1811594385 Christine Young Nurse Practitioner 6804 Bainbridge Ct, Louisville, KY 40228-2335 2020-10-07
1285243477 Stephanie Atherton Nurse Practitioner 1623 Story Ave, Louisville, KY 40206 2020-07-24
1235768037 Patricia Amber Estes Nurse Practitioner 234 E Gray St Ste 154, Louisville, KY 40202-1903 2020-04-03
1659903201 Farrah Alayne Thornsberry Nurse Practitioner 1400 Browns Ln Ste B, Louisville, KY 40207-4696 2020-02-11
1376101634 Erin Lee Srader Nurse Practitioner 544 Baxter Ave, Louisville, KY 40204-1784 2019-06-03
1104387752 Kurt F Kristiansen Nurse Practitioner 1862 Douglass Blvd, Louisville, KY 40205-1851 2019-03-27
1831573351 Karen P Black Nurse Practitioner 4504 Spring Bay Ct, Louisville, KY 40241-1773 2015-07-14
1366787798 Kennetha Porter Nurse Practitioner 4710 Champions Trace Ln Ste 102, Louisville, KY 40218-3496 2012-12-12
1407104128 Tammy Rowland Reddington Nurse Practitioner 4004 Hurstbroune Woods Drive, Louisville, KY 40299 2012-08-28
1326311168 Audrey Yvonne Naser Nurse Practitioner 3303 Trail Ridge Rd, Louisville, KY 40241-6402 2012-02-09
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Competitor

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City LOUISVILLE
Zip Code 40219

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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