Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Magnolia Psychiatry

Organization Psychiatric/Mental Health Nurse Practitioner · NPI 1255090510

Magnolia Psychiatry is a Psychiatric/Mental Health Nurse Practitioner in Louisville, Kentucky. Works from 2 locations. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

312 S 4th St Ste 700
Louisville, KY 40202-3046
Phone: (615) 813-0726
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4523 Shady Place Ct, Bowling Green, KY 42104-4423 — (937) 285-0414

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X

Record details

NPI number1255090510
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Angel Squire — Owner · (615) 813-0726
NPI enumeratedDecember 14, 2021
Last updated in NPPESFebruary 3, 2022
Certification dateFebruary 3, 2022
Mailing address4523 Shady Place Ct, Bowling Green, KY 42104-4423

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