MEDICARE: ANDILOU LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
3	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1871444265
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDILOU LLC

Provider Business Mailing Address
First Line	:	1020 INDUSTRY RD STE 32
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40505-3829
Country	:	US
Telephone Number	:	859-797-4304
Fax Number	:

Provider Business Practice Location Address
First Line	:	1020 INDUSTRY RD STE 32
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40505-3829
Country	:	US
Telephone Number	:	859-797-4304
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANDREE DEIFEL
Credential	:	NP
Telephone Number	:	859-797-4304

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	05/28/2026

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Directions to “ANDILOU LLC ” Practice Location

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