=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578492716
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | THERESE RABBITT CSFA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/14/2026
-----------------------------------------------------
Last Update Date | 05/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 150 N EAGLE CREEK DR
-----------------------------------------------------
City | LEXINGTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40509-1805
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-967-5000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4030 TATES CREEK RD APT 5507
-----------------------------------------------------
City | LEXINGTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40517-3191
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-460-3214
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 246ZC0007X
-----------------------------------------------------
Taxonomy Name | Surgical Assistant
-----------------------------------------------------
License Number | SA483
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------