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General NPI Number Information
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NPI Number | 1740194646
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Entity Type | Individual
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Provider Name | LIDIA MARIA VAZQUEZ
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Gender | Female
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Dates
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Enumeration Date | 09/29/2026
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 1530 LONE OAK RD
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City | PADUCAH
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State | KY
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Zip | 42003-7901
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Country | US
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Telephone | 270-444-2444
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Fax |
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Provider Business Mailing Address
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Address Line | 5343 SHELLDRAKE LN
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City | PADUCAH
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State | KY
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Zip | 42001-9554
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Country | US
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Telephone | 270-978-6009
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 1169487
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License Number State | KY
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