Healthcare Provider Details

I. General information

NPI: 1952674574
Provider Name (Legal Business Name): LEXINGTON PRIMARY CARE ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2012
Last Update Date: 05/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 N EAGLE CREEK DR STE 320
LEXINGTON KY
40509-1889
US

IV. Provider business mailing address

151 N EAGLE CREEK DR STE 320
LEXINGTON KY
40509-1889
US

V. Phone/Fax

Practice location:
  • Phone: 859-543-0005
  • Fax: 859-543-0474
Mailing address:
  • Phone: 859-543-0005
  • Fax: 859-543-0474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: GITANA B COLE
Title or Position: APRN / OWNER
Credential: APRN
Phone: 859-543-0005