Healthcare Provider Details

I. General information

NPI: 1962820472
Provider Name (Legal Business Name): ASHLEY BRUNMEIER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2014
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536
US

IV. Provider business mailing address

900 S LIMESTONE CTW 326
LEXINGTON KY
40536-0293
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-0295
  • Fax: 859-323-1256
Mailing address:
  • Phone: 859-323-8040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0002X
TaxonomyAdult Congenital Heart Disease Physician
License Number51659
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number51659
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: