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General NPI Number Information
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NPI Number | 1407746449
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Entity Type | Individual
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Provider Name | MAKAYLA HAWKINS MOYNAGH APRN
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Gender | Female
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Dates
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Enumeration Date | 07/09/2025
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 1350 BULL LEA RD
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City | LEXINGTON
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State | KY
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Zip | 40511-1247
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Country | US
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Telephone | 859-246-8000
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Fax | 859-246-8032
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Provider Business Mailing Address
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Address Line | 312 BRIDLEWOOD AVE
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City | SHELBYVILLE
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State | KY
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Zip | 40065-7209
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Country | US
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Telephone | 502-320-0814
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4038798
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License Number State | KY
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