Healthcare Provider Details

I. General information

NPI: 1255735429
Provider Name (Legal Business Name): ROBERT RANDOLPH MORLEY II APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2014
Last Update Date: 10/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1517 NICHOLASVILLE RD STE 201
LEXINGTON KY
40503-1429
US

IV. Provider business mailing address

1517 NICHOLASVILLE RD STE 201
LEXINGTON KY
40503-1429
US

V. Phone/Fax

Practice location:
  • Phone: 859-286-2592
  • Fax: 859-287-2492
Mailing address:
  • Phone: 859-286-2592
  • Fax: 859-287-2492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License Number3009014
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: