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General NPI Number Information
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NPI Number | 1205062478
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Entity Type | Organization
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Legal Business Name | BLUEGRASS SURGICAL ASSISTANTS, PSC
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Dates
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Enumeration Date | 06/02/2009
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Last Update Date | 09/25/2014
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Provider Practice Location Address
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Address Line | 4310 BETHEL RD
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City | LEXINGTON
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State | KY
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Zip | 40511-9034
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Country | US
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Telephone | 859-552-7700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 13545
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City | LEXINGTON
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State | KY
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Zip | 40583-3545
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Country | US
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Telephone | 859-552-7700
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Fax |
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Authorized Official
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Title or Position | ADVANCED NURSE PRACTITIONER/OWNER
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Name | SHIRLEY POLLARD RAMSEY
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Credential | APRN
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Telephone | 859-552-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3005822
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License Number State | KY
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