Healthcare Provider Details

I. General information

NPI: 1629201835
Provider Name (Legal Business Name): LEXI DAWN TUBBS LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEXI SHARON ROSALES

II. Dates (important events)

Enumeration Date: 09/03/2009
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 MILLERSBURG RD
PARIS KY
40361-2145
US

IV. Provider business mailing address

1237 ARLINGTON DR
PARIS KY
40361-2200
US

V. Phone/Fax

Practice location:
  • Phone: 859-987-6058
  • Fax:
Mailing address:
  • Phone: 859-707-0326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: