Healthcare Provider Details

I. General information

NPI: 1770176992
Provider Name (Legal Business Name): KYMBERLY LITTLE-BAILEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KYMBERLY LITTLE BAILEY APRN

II. Dates (important events)

Enumeration Date: 02/18/2021
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536-7001
US

IV. Provider business mailing address

800 ROSE ST
LEXINGTON KY
40536-7001
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-6047
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number3015203
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3015203
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: