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General NPI Number Information
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NPI Number | 1609712256
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Entity Type | Individual
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Provider Name | ALLISON GRACE KIDWELL
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Gender | Female
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Dates
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Enumeration Date | 04/27/2026
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Last Update Date | 04/27/2026
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Provider Practice Location Address
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Address Line | 900 S LIMESTONE ST ROOM 205
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City | LEXINGTON
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State | KY
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Zip | 40536-0001
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Country | US
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Telephone | 859-218-0567
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Fax |
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Provider Business Mailing Address
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Address Line | 104 BRUNER DR
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City | WILMORE
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State | KY
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Zip | 40390-9725
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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