Healthcare Provider Details

I. General information

NPI: 1013151711
Provider Name (Legal Business Name): JUDY ANN HARRISON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. JUDY ANN TURPIN

II. Dates (important events)

Enumeration Date: 04/24/2009
Last Update Date: 04/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

961 BEASLEY ST STE 170
LEXINGTON KY
40509-4120
US

IV. Provider business mailing address

650 NEWTOWN PIKE
LEXINGTON KY
40508-1113
US

V. Phone/Fax

Practice location:
  • Phone: 859-226-5022
  • Fax: 859-226-5025
Mailing address:
  • Phone: 859-288-2425
  • Fax: 859-288-7516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number3006997
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1060801
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: