Healthcare Provider Details

I. General information

NPI: 1740591601
Provider Name (Legal Business Name): CENTRAL KY NEPHROLOGY & HYPERTENSION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2010
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 NICHOLASVILLE RD STE 303
LEXINGTON KY
40503-2526
US

IV. Provider business mailing address

1451 HARRODSBURG RD SUITE D-304
LEXINGTON KY
40504-3758
US

V. Phone/Fax

Practice location:
  • Phone: 859-373-1176
  • Fax: 859-275-0028
Mailing address:
  • Phone: 859-977-4000
  • Fax: 859-977-5100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number StateKY

VIII. Authorized Official

Name: MRS. CARRIE DELEAN REED
Title or Position: OFFICE MANAGER
Credential:
Phone: 859-576-2831