Healthcare Provider Details

I. General information

NPI: 1952800195
Provider Name (Legal Business Name): KYLA LEE GILBERT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KYLA LEE ANDERSON APRN

II. Dates (important events)

Enumeration Date: 02/02/2018
Last Update Date: 02/15/2022
Certification Date: 02/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 S LIMESTONE STE B101
LEXINGTON KY
40536
US

IV. Provider business mailing address

425 LEWIS HARGETT CIR
LEXINGTON KY
40503-3590
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5661
  • Fax: 859-323-5943
Mailing address:
  • Phone: 859-268-1030
  • Fax: 859-269-4120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License Number3012047
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3012047
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: