1134226434 NPI number — MS. STACY LYNN MILLS APRN

Table of content: MS. STACY LYNN MILLS APRN (NPI 1134226434)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134226434 NPI number — MS. STACY LYNN MILLS APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILLS
Provider First Name:
STACY
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134226434
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1733 HARRODSBURG RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40504-3277
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-278-4869
Provider Business Mailing Address Fax Number:
859-278-7690

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1733 HARRODSBURG RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40504-3277
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-278-4869
Provider Business Practice Location Address Fax Number:
859-278-7690
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  3004942 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: K038842 . This is a "OWINGSVILLE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: K038843 . This is a "MOREHEAD" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: K038844 . This is a "FRENCHBURG" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: K038845 . This is a "MEDICARE EXPRESS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: K038847 . This is a "SANDY HOOK" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: K038848 . This is a "MEDICARE MOREHEAD MEDICAL SPECIALISTS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: K038846 . This is a "OLIVE HILL" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 3004942 . This is a "STATE LICENSE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 7100001820 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com