Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 33224 | KY |
Y | 207Q00000X | Family Doctor | 33224 | KY |
N | 207RA0401X | Internist - Addiction Medicine | 33224 | KY |
NPI | 1013930759 |
---|---|
Provider Name | Traci Westerfield |
First Address | Lexington, KY 40503-2925 |
Second Address | Lexington, KY 40503-2954 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 16/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000260141 | ANTHEM (01) | KY |
64057243 | (05) | KY |
H75145 | (02) | KY |
P00104776 | RR-MEDICARE (01) | KY |