Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 3010364 | KY |
NPI | 1003266933 |
---|---|
Provider Name | Leah Ray Yeager |
First Address | Lexington, KY 40536-7001 |
Second Address | Lexington, KY 40536-7001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2016 |
Last Update Date | 22/06/2016 |