Healthcare Provider Details

I. General information

NPI: 1194731919
Provider Name (Legal Business Name): RITA MARIE PAXSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 10/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 RICHMOND RD
LEXINGTON KY
40509-1599
US

IV. Provider business mailing address

166 PASADENA DR
LEXINGTON KY
40503-2973
US

V. Phone/Fax

Practice location:
  • Phone: 859-268-9866
  • Fax: 859-268-0458
Mailing address:
  • Phone: 859-278-0319
  • Fax: 859-277-9699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number1036392
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3004097
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: