MEDICARE: KAY C STEPHENS APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	3002572	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000325551	OTHER	KY	ANTHEM BCBS
2	0007093299	OTHER	KY	AETNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013902584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAY C STEPHENS APRN

Provider Business Mailing Address
First Line	:	PO BOX 35
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40476-0035
Country	:	US
Telephone Number	:	859-626-9696
Fax Number	:	859-626-9662

Provider Business Practice Location Address
First Line	:	312 JASON DR
Second Line	:	SUITE 9
City	:	RICHMOND
State	:	KY
Zip	:	40475-2785
Country	:	US
Telephone Number	:	859-626-9696
Fax Number	:	859-626-9662

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	01/20/2011

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Directions to “ KAY C STEPHENS APRN” Practice Location

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