Healthcare Provider Details

I. General information

NPI: 1700576709
Provider Name (Legal Business Name): KENDRA ALEXIS VROMAN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2023
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 S LIMESTONE STE D135
LEXINGTON KY
40536-3276
US

IV. Provider business mailing address

740 S LIMESTONE STE D135
LEXINGTON KY
40536-0001
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5533
  • Fax: 859-257-3634
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberTC046
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberTC046
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberTC046
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: