Healthcare Provider Details

I. General information

NPI: 1619420544
Provider Name (Legal Business Name): LYDIA NORTON CHEEKS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2016
Last Update Date: 04/13/2021
Certification Date: 04/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536-0001
US

IV. Provider business mailing address

UK DIVISION OF PULMONARY CRITICAL CARE 740 S. LIMESTONE, L543 KY CLINIC
LEXINGTON KY
40536-0001
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-8072
  • Fax: 859-257-9691
Mailing address:
  • Phone: 859-323-5045
  • Fax: 859-257-2418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number3010424
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3010424
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: