Provider Demographics
NPI:1609399674
Name:SASSER, GERALDINE ANN (APRN, PMHNP)
Entity type:Individual
Prefix:MRS
First Name:GERALDINE
Middle Name:ANN
Last Name:SASSER
Suffix:
Gender:F
Credentials:APRN, PMHNP
Other - Prefix:MRS
Other - First Name:GERI
Other - Middle Name:A
Other - Last Name:SASSER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN, PMHNP
Mailing Address - Street 1:PO BOX 809
Mailing Address - Street 2:
Mailing Address - City:CRESTWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:40014-0809
Mailing Address - Country:US
Mailing Address - Phone:502-709-5386
Mailing Address - Fax:502-653-7575
Practice Address - Street 1:2815 TAYLORSVILLE RD STE 102
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2100
Practice Address - Country:US
Practice Address - Phone:502-709-5386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-21
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3011546363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health