MEDICARE: YANA ANATOLYEVNA GUMENYUK 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	363LN0000X	Neonatal Nurse Practitioner	4038838	KY
2	163WN0002X	Neonatal Intensive Care Registered Nurse	1157041	KY

General Provider Information

NPI Number	:	1609603778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANA ANATOLYEVNA GUMENYUK APRN

Provider Business Mailing Address
First Line	:	800 ROSE ST 1ST FL
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40536-0293
Country	:	US
Telephone Number	:	859-562-1085
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 ROSE ST
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40536-7001
Country	:	US
Telephone Number	:	859-323-5000
Fax Number	:

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

Provider Enumeration Date	:	09/13/2024
Last Update Date	:	02/04/2026

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