Healthcare Provider Details

I. General information

NPI: 1275975955
Provider Name (Legal Business Name): KARA STEBBINS, MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2013
Last Update Date: 01/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

832 TREMONT AVE
LEXINGTON KY
40502-2234
US

IV. Provider business mailing address

832 TREMONT AVE
LEXINGTON KY
40502-2234
US

V. Phone/Fax

Practice location:
  • Phone: 859-494-6223
  • Fax:
Mailing address:
  • Phone: 859-576-2776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number46548
License Number StateKY

VIII. Authorized Official

Name: KARA STEBBINS
Title or Position: SOLE MEMBER
Credential:
Phone: 859-494-6223