Healthcare Provider Details

I. General information

NPI: 1982298717
Provider Name (Legal Business Name): LAUREN VINCENT BESEDNJAK BSN, RN, SANE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2021
Last Update Date: 03/18/2021
Certification Date: 03/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536-7001
US

IV. Provider business mailing address

138 LEADER AVE
LEXINGTON KY
40508-3215
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-4427
  • Fax:
Mailing address:
  • Phone: 859-218-6727
  • Fax: 859-257-1888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number1106509
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: