Provider Demographics
NPI:1003490442
Name:PELLMAN, CHRISTINA MARIE (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MARIE
Last Name:PELLMAN
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11909 SHELBYVILLE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243-1453
Mailing Address - Country:US
Mailing Address - Phone:502-747-1503
Mailing Address - Fax:502-237-6964
Practice Address - Street 1:11909 SHELBYVILLE RD STE 100
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-1453
Practice Address - Country:US
Practice Address - Phone:502-747-1503
Practice Address - Fax:502-237-6964
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017428363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health