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Organization
RESILIENT MINDS LLC
Active
Organization
RESILIENT MINDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMICKY TACHELL DAVIS NP (PMHNP)
(502) 403-4365
Entity
Organization
Contact information
Practice address
2210 GOLDSMITH LANE, SUITE 126 PMB 4063, LOUISVILLE, KY 40218
(502) 403-4365
Mailing address
2210 GOLDSMITH LANE, SUITE 126 PMB 4063, LOUISVILLE, KY 40218
(502) 403-4365
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/28/2024
Last updated
09/28/2024
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