Healthcare Provider Details

I. General information

NPI: 1346508173
Provider Name (Legal Business Name): KENTUCKY AUDIOLOGY & TINNITUS SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2012
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1517 NICHOLASVILLE RD STE 202
LEXINGTON KY
40503-1429
US

IV. Provider business mailing address

1517 NICHOLASVILLE RD STE 202
LEXINGTON KY
40503-1429
US

V. Phone/Fax

Practice location:
  • Phone: 859-554-5384
  • Fax: 859-554-6173
Mailing address:
  • Phone: 859-554-5384
  • Fax: 859-554-6173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number0146
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number0431
License Number StateKY

VIII. Authorized Official

Name: STACY JANE JARRETT
Title or Position: OWNER
Credential: AUD
Phone: 859-554-5384