Healthcare Provider Details

I. General information

NPI: 1649968256
Provider Name (Legal Business Name): LONNA KAY GILBERT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2023
Last Update Date: 05/01/2023
Certification Date: 05/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 ENTERPRISE DR
WINCHESTER KY
40391-9668
US

IV. Provider business mailing address

2424 SIR BARTON WAY STE 175
LEXINGTON KY
40509-2531
US

V. Phone/Fax

Practice location:
  • Phone: 859-745-8169
  • Fax:
Mailing address:
  • Phone: 859-745-8169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0106X
TaxonomyOccupational Health Registered Nurse
License Number1146568
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: