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Organization

COMMONWEALTH OF KENTUCKY

Active
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Organization

COMMONWEALTH OF KENTUCKY

Active
Other names
ESH APRN Group
Organization subpart
No

Provider details

NPI number
Authorized official
CARRIE RUDZIK (CAO)
(859) 246-8204
Entity
Organization

Contact information

Practice address
1350 BULL LEA RD, LEXINGTON, KY 40511-1247
(859) 246-8000
(859) 246-8043
Mailing address
1350 BULL LEA RD, LEXINGTON, KY 40511-1247
(859) 246-8000
(859) 246-8043

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—

Other

Enumeration date
10/20/2016
Last updated
10/20/2016
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