Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 1036392 | KY |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 3004097 | KY |
NPI | 1194731919 |
---|---|
Provider Name | Rita Marie Paxson |
First Address | Lexington, KY 40503-2973 |
Second Address | Lexington, KY 40509-1599 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 30/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000000309461 | ANTHEM (01) | KY |
78010592 | (05) | KY |
P94578 | (02) |