Healthcare Provider Details

I. General information

NPI: 1740196187
Provider Name (Legal Business Name): FAST PACE KENTUCKY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

673 CARDINAL DR
HENDERSON NC
27536-5105
US

IV. Provider business mailing address

PO BOX 306599
NASHVILLE TN
37230-6599
US

V. Phone/Fax

Practice location:
  • Phone: 252-654-6406
  • Fax: 252-654-6407
Mailing address:
  • Phone: 931-253-1110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTY LITTLEJOHN
Title or Position: SR MANAGER
Credential:
Phone: 931-253-1110