Healthcare Provider Details

I. General information

NPI: 1932687308
Provider Name (Legal Business Name): KELLY ELIZABETH LYONS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2018
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UK HEMATOLOGY/ BMT CLINIC 800 ROSE ST ROACH CANCER CTR 1ST FL
LEXINGTON KY
40536-0298
US

IV. Provider business mailing address

125 FOXGLOVE DR STE B
MOUNT STERLING KY
40353-9735
US

V. Phone/Fax

Practice location:
  • Phone: 859-257-6006
  • Fax:
Mailing address:
  • Phone: 859-520-9292
  • Fax: 859-520-9004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number3012248
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3012248
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number3012248
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: