Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | R3780 | KY |
NPI | 1013398882 |
---|---|
Provider Name | Ashley Erin Green |
First Address | Lexington, KY 40536-0001 |
Second Address | Lexington, KY 40536-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2015 |
Last Update Date | 06/01/2017 |