Healthcare Provider Details

I. General information

NPI: 1407792047
Provider Name (Legal Business Name): ASHLEY ANDERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ASHLEY REID

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S LIMESTONE ST
LEXINGTON KY
40536-0001
US

IV. Provider business mailing address

446 CULPEPPER RD APT 1
LEXINGTON KY
40502-2361
US

V. Phone/Fax

Practice location:
  • Phone: 859-354-9810
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: