Provider Demographics
NPI:1497706345
Name:MASON, NOREEN C (APRN)
Entity type:Individual
Prefix:MRS
First Name:NOREEN
Middle Name:C
Last Name:MASON
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 CHEROKEE RD STE 4A
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40204-1270
Mailing Address - Country:US
Mailing Address - Phone:502-536-8337
Mailing Address - Fax:502-885-4504
Practice Address - Street 1:1000 CHEROKEE RD STE 4A
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40204-1270
Practice Address - Country:US
Practice Address - Phone:502-536-8337
Practice Address - Fax:502-885-4504
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3004179363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78011244Medicaid
KY0048458Medicare PIN
KY78011244Medicaid
KYP400025747Medicare PIN
KY0523970Medicare PIN