Healthcare Provider Details

I. General information

NPI: 1528041217
Provider Name (Legal Business Name): WOMEN'S CARE OF THE BLUEGRASS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 06/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 C. MICHAEL DAVENPORT BLVD
FRANKFORT KY
40601-4324
US

IV. Provider business mailing address

89 C. MICHAEL DAVENPORT BLVD
FRANKFORT KY
40601-4324
US

V. Phone/Fax

Practice location:
  • Phone: 502-227-2229
  • Fax: 502-227-1114
Mailing address:
  • Phone: 502-227-2229
  • Fax: 502-227-1114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN HALL
Title or Position: PARTNER
Credential: M.D.
Phone: 502-227-2229