Healthcare Provider Details

I. General information

NPI: 1700536174
Provider Name (Legal Business Name): AMANDA ASHLEY HOSKINS HENDERSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA ASHLEY HOSKINS

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST FL 4
LEXINGTON KY
40536-0293
US

IV. Provider business mailing address

800 ROSE ST RM MN-472
LEXINGTON KY
40536-0293
US

V. Phone/Fax

Practice location:
  • Phone: 859-218-2581
  • Fax: 859-257-1632
Mailing address:
  • Phone: 859-323-5157
  • Fax: 859-323-1214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number60915
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: