Healthcare Provider Details

I. General information

NPI: 1073124202
Provider Name (Legal Business Name): LEZLEE DELANEY LPN NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2020
Last Update Date: 08/12/2020
Certification Date: 08/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1974 WALTON NICHOLSON PIKE
INDEPENDENCE KY
41051-7906
US

IV. Provider business mailing address

6455 LAKEARBOR DR
INDEPENDENCE KY
41051-8353
US

V. Phone/Fax

Practice location:
  • Phone: 859-359-5404
  • Fax:
Mailing address:
  • Phone: 859-462-3446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number56434
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: