Healthcare Provider Details

I. General information

NPI: 1962469007
Provider Name (Legal Business Name): AMY R COMER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 VETERANS DR
LEXINGTON KY
40502-2235
US

IV. Provider business mailing address

1101 VETERANS DR
LEXINGTON KY
40502-2235
US

V. Phone/Fax

Practice location:
  • Phone: 859-281-4949
  • Fax: 859-281-3823
Mailing address:
  • Phone: 859-281-4949
  • Fax: 859-281-3823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3004667
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: