Healthcare Provider Details

I. General information

NPI: 1952218380
Provider Name (Legal Business Name): KENTUCKY HEALTH SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 CUSTER DR STE 101
LEXINGTON KY
40517-4010
US

IV. Provider business mailing address

3150 CUSTER DR STE 101
LEXINGTON KY
40517-4010
US

V. Phone/Fax

Practice location:
  • Phone: 502-219-3488
  • Fax: 502-406-5803
Mailing address:
  • Phone: 502-219-3488
  • Fax: 502-406-5803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MARY PATRICIA JARNAGIN
Title or Position: OWNER
Credential:
Phone: 502-219-3488