Healthcare Provider Details

I. General information

NPI: 1902469737
Provider Name (Legal Business Name): PATRICK SARCINELLA APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2019
Last Update Date: 02/18/2024
Certification Date: 02/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536-1488
US

IV. Provider business mailing address

1720 NICHOLASVILLE RD STE 602
LEXINGTON KY
40503-1488
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5956
  • Fax: 859-323-1080
Mailing address:
  • Phone: 859-277-4005
  • Fax: 859-278-2507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number3013213
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number3013213
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: