Individual
KATHLEEN B BERGHAUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
417 BENJAMIN LN STE 101, LOUISVILLE, KY 40222-4939
(502) 289-9306
(502) 385-6687
Mailing address
9642 BROWNSBORO RD #154, LOUISVILLE, KY 40241-8042
(502) 558-0916
(502) 385-6687
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3015109
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3015109
—
KY
Enumeration date
09/25/2020
Last updated
06/02/2023
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