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General NPI Number Information
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NPI Number | 1477280600
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Entity Type | Individual
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Provider Name | CODY VANCE SCOVEL CRNA
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Gender | Male
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Dates
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Enumeration Date | 08/08/2022
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Last Update Date | 05/24/2026
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Provider Practice Location Address
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Address Line | 2620 WILHITE DR
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City | LEXINGTON
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State | KY
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Zip | 40503-3385
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Country | US
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Telephone | 859-278-0185
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Fax |
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Provider Business Mailing Address
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Address Line | 430 BARKLEY DR
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City | LEXINGTON
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State | KY
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Zip | 40503-1849
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Country | US
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Telephone | 860-316-7212
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP61328552
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License Number State | WA
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