Healthcare Provider Details

I. General information

NPI: 1265759203
Provider Name (Legal Business Name): PATRICIA K GARRETT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2010
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 MONARCH ST STE 300
LEXINGTON KY
40513-1877
US

IV. Provider business mailing address

1050 MONARCH ST STE 300
LEXINGTON KY
40513-1877
US

V. Phone/Fax

Practice location:
  • Phone: 859-286-9951
  • Fax: 859-286-9952
Mailing address:
  • Phone: 859-286-9951
  • Fax: 859-286-9952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA1556
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: