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NPI Code Detail

MEDICARE: LOVORIA BRECKLEY WILLIAMS NP

MEDICARE: LOVORIA BRECKLEY WILLIAMS NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner3012759KY

General Provider Information

NPI Number : 1811007180
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOVORIA BRECKLEY WILLIAMS NP
Provider Business Mailing Address
First Line : 751 ROSE ST
Second Line :
City : LEXINGTON
State : KY
Zip : 40536-7000
Country : US
Telephone Number : 859-323-5579
Fax Number :
Provider Business Practice Location Address
First Line : 1350 BULL LEA RD
Second Line :
City : LEXINGTON
State : KY
Zip : 40511-1247
Country : US
Telephone Number : 859-246-7802
Fax Number : 859-323-1057
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 02/26/2019

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