Healthcare Provider Details

I. General information

NPI: 1033787031
Provider Name (Legal Business Name): ALEXIS NOEL BUDINE-UTTER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2021
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 HOSPITAL DR
WINCHESTER KY
40391-7604
US

IV. Provider business mailing address

2416 REGENCY RD
LEXINGTON KY
40503-2954
US

V. Phone/Fax

Practice location:
  • Phone: 859-737-6559
  • Fax: 859-737-6560
Mailing address:
  • Phone: 859-278-1316
  • Fax: 859-276-3847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA2837
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: