Healthcare Provider Details

I. General information

NPI: 1457240897
Provider Name (Legal Business Name): MAKAYLA LOUISE SLONE PA-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 NICHOLASVILLE RD STE 101
LEXINGTON KY
40503-1410
US

IV. Provider business mailing address

1760 NICHOLASVILLE RD STE 101
LEXINGTON KY
40503-1410
US

V. Phone/Fax

Practice location:
  • Phone: 859-899-7950
  • Fax: 859-260-5150
Mailing address:
  • Phone: 859-899-7950
  • Fax: 859-260-5150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberTC130
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: