Healthcare Provider Details

I. General information

NPI: 1750824116
Provider Name (Legal Business Name): LORI G DENISON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2016
Last Update Date: 10/14/2022
Certification Date: 10/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2036 REGENCY RD STE 2
LEXINGTON KY
40503-2309
US

IV. Provider business mailing address

2036 REGENCY RD STE 2
LEXINGTON KY
40503-2309
US

V. Phone/Fax

Practice location:
  • Phone: 859-286-9046
  • Fax: 859-276-3726
Mailing address:
  • Phone: 859-286-9046
  • Fax: 859-276-3726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number3010876
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3010876
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: