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NPI Code Detail

MEDICARE: CARMELA FLETCHER-GREEN PA-C

MEDICARE: CARMELA FLETCHER-GREEN PA-C
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
1363AM0700XMedical Physician AssistantPA304KY
2363A00000XPhysician AssistantPA304KY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3970021336OTHERKYRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111478958OTHERKYCAQH
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518948769
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARMELA FLETCHER-GREEN PA-C
Provider Business Mailing Address
First Line : 1306 VERSAILLES RD STE 120
Second Line :
City : LEXINGTON
State : KY
Zip : 40504-1795
Country : US
Telephone Number : 859-259-2635
Fax Number : 592-547-8748
Provider Business Practice Location Address
First Line : 1306 VERSAILLES RD STE 120
Second Line :
City : LEXINGTON
State : KY
Zip : 40504-1795
Country : US
Telephone Number : 859-259-2635
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2005
Last Update Date : 06/22/2022

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Directions to “ CARMELA FLETCHER-GREEN PA-C” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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