Healthcare Provider Details

I. General information

NPI: 1447145651
Provider Name (Legal Business Name): ALEXA SHAYE DAMRON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 HOSPITAL RD
WHITESBURG KY
41858-7627
US

IV. Provider business mailing address

205 CHARLES T WETHINGTON BUILDING
LEXINGTON KY
40536-0001
US

V. Phone/Fax

Practice location:
  • Phone: 606-633-3500
  • Fax:
Mailing address:
  • Phone: 859-257-5001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberTC135
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: