Healthcare Provider Details

I. General information

NPI: 1275455990
Provider Name (Legal Business Name): EPISKEY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 RIDGE BROOK DR
MT WASHINGTON KY
40047-5782
US

IV. Provider business mailing address

200 RIDGE BROOK DR
MT WASHINGTON KY
40047-5782
US

V. Phone/Fax

Practice location:
  • Phone: 502-751-8803
  • Fax:
Mailing address:
  • Phone: 502-751-8803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name: MARTHA NICKCO TREBOR
Title or Position: CSFA
Credential: CSFA
Phone: 502-751-8803