Healthcare Provider Details

I. General information

NPI: 1962416792
Provider Name (Legal Business Name): WOMEN'S CARE CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 03/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 NICHOLASVILLE RD. SUITE 402
LEXINGTON KY
40503
US

IV. Provider business mailing address

1720 NICHOLASVILLE RD. SUITE 402
LEXINGTON KY
40503
US

V. Phone/Fax

Practice location:
  • Phone: 859-278-0363
  • Fax: 859-278-5317
Mailing address:
  • Phone: 859-278-0363
  • Fax: 859-278-5317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberGUIL-0427-6664
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. KIM CANTER
Title or Position: ADMINISTRATIVE ASSITANT
Credential:
Phone: 859-278-0363