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General NPI Number Information
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NPI Number | 1023249950
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Entity Type | Individual
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Provider Name | REECA L PRATER L.P.N., L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 07/27/2009
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Last Update Date | 07/27/2009
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Provider Practice Location Address
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Address Line | 125 CODELL DR SUITE 116
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City | LEXINGTON
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State | KY
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Zip | 40509-1183
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Country | US
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Telephone | 859-433-1693
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Fax |
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Provider Business Mailing Address
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Address Line | 125 CODELL DR SUITE 116
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City | LEXINGTON
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State | KY
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Zip | 40509-1183
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Country | US
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Telephone | 859-433-1693
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 2030736
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | KY-0707
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License Number State | KY
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