Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 45156 | KY |
Y | 111NI0900X | Internist | 45156 | KY |
N | 207RA0401X | Internist - Addiction Medicine | 45156 | KY |
NPI | 1811156870 |
---|---|
Provider Name | Laura Fanucchi |
First Address | Lexington, KY 40536-0001 |
Second Address | Lexington, KY 40536-0200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2008 |
Last Update Date | 29/03/2018 |