Healthcare Provider Details

I. General information

NPI: 1487746004
Provider Name (Legal Business Name): LYNNELLE CAIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 07/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1509 LOUISVILLE RD
HARRODSBURG KY
40330-8622
US

IV. Provider business mailing address

PO BOX 990
DANVILLE KY
40423-0990
US

V. Phone/Fax

Practice location:
  • Phone: 859-734-5770
  • Fax: 859-239-6898
Mailing address:
  • Phone: 859-239-2379
  • Fax: 859-239-6898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4539P
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: