# LEBANON PEDIATRICS LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LEBANON PEDIATRICS, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1063686509
- **Legal business name:** LEBANON PEDIATRICS, LLC
- **Authorized official:** DR. DIANE S THOMAS M.D. (PRESIDENT)
- **Authorized official phone:** (270) 692-5811

## Contact information

- **Practice address:** 311 W HIGH ST, LEBANON, KY 40033-1427
- **Practice address phone:** (270) 692-5811
- **Practice address fax:** (270) 692-3863
- **Mailing address:** 311 W HIGH ST, LEBANON, KY 40033-1427
- **Mailing address phone:** (270) 692-5811
- **Mailing address fax:** (270) 692-3863

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/16/2008
- **Last updated:** 04/16/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 78905148 | — | KY |