Healthcare Provider Details

I. General information

NPI: 1992982888
Provider Name (Legal Business Name): KENTUCKY AESTHETIC & PLASTIC SURGERY INSTITUTE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2008
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 TERRA CROSSING BLVD
LOUISVILLE KY
40245-5350
US

IV. Provider business mailing address

2950 TERRA CROSSING BLVD
LOUISVILLE KY
40245-5350
US

V. Phone/Fax

Practice location:
  • Phone: 502-589-5544
  • Fax: 502-561-0040
Mailing address:
  • Phone: 502-589-5544
  • Fax: 502-561-0040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number2086S0122X
License Number StateKY

VIII. Authorized Official

Name: MS. EMILY M DIGENIS
Title or Position: CFO
Credential: JD
Phone: 502-589-5544