Healthcare Provider Details

I. General information

NPI: 1194947598
Provider Name (Legal Business Name): ROBERT HERRON ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

627 W 4TH ST
LEXINGTON KY
40508-1207
US

IV. Provider business mailing address

4693 SPRING CREEK DR
LEXINGTON KY
40515-1506
US

V. Phone/Fax

Practice location:
  • Phone: 859-246-7363
  • Fax: 859-246-7023
Mailing address:
  • Phone: 859-246-7000
  • Fax: 859-246-7023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1085786
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4436P
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: