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Organization
TIA BRAXTON, APRN, PMHNP-BC, PLLC
Active
Organization
TIA BRAXTON, APRN, PMHNP-BC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIA PATRICE BRAXTON MSN, APRN, PMHNP-BC (OWNER)
(502) 999-2855
Entity
Organization
Contact information
Practice address
6540 OUTERLOOP STE 6, LOUISVILLE, KY 40228
(502) 999-2855
(502) 416-1493
Mailing address
8813 ARISTIDES DR, LOUISVILLE, KY 40258-1735
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/17/2023
Last updated
08/18/2026
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