Healthcare Provider Details

I. General information

NPI: 1811804164
Provider Name (Legal Business Name): AVENMERE HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 AMANDA DR
LONDON KY
40744-8398
US

IV. Provider business mailing address

51 AMANDA DR
LONDON KY
40744-8398
US

V. Phone/Fax

Practice location:
  • Phone: 606-305-9892
  • Fax:
Mailing address:
  • Phone: 606-305-9892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. AUSTIN LANE ANDERSON
Title or Position: OWNER
Credential: FNP-BC
Phone: 606-305-9892