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Organization
PATRIOT ONE PRIMARY CARE PSC
Active
Organization
PATRIOT ONE PRIMARY CARE PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANINE LIPPERT PCNP-PC (NURSE PRACTITIONER)
(859) 433-4661
Entity
Organization
Contact information
Practice address
989 GOVERNORS LN STE 140, LEXINGTON, KY 40513-1174
(859) 447-8014
Mailing address
989 GOVERNORS LN STE 220, LEXINGTON, KY 40513-1175
(859) 447-8014
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100137000
—
KY
Enumeration date
04/20/2022
Last updated
08/02/2022
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