Healthcare Provider Details
I. General information
NPI: 1184616484
Provider Name (Legal Business Name): JAMES ANDREW DUFF CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/22/2005
Last Update Date: 09/29/2026
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
150 N EAGLE CREEK DR
LEXINGTON KY
40509-1805
US
IV. Provider business mailing address
425 LEWIS HARGETT CIR
LEXINGTON KY
40503-3590
US
V. Phone/Fax
- Phone: 859-967-5000
- Fax:
- Phone: 859-268-1030
- Fax: 859-269-4120
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | 4200A |
| License Number State | KY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: