# TIA BRAXTON, APRN, PMHNP-BC, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134821945
- **Authorized official:** TIA PATRICE BRAXTON MSN, APRN, PMHNP-BC (OWNER)
- **Authorized official phone:** (502) 999-2855

## Contact information

- **Practice address:** 6540 OUTERLOOP STE 6, LOUISVILLE, KY 40228
- **Practice address phone:** (502) 999-2855
- **Practice address fax:** (502) 416-1493
- **Mailing address:** 8813 ARISTIDES DR, LOUISVILLE, KY 40258-1735

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 03/17/2023
- **Last updated:** 08/18/2026