# BLUEGRASS PRIMARY CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649222969
- **Authorized official:** ANN S. GILES (OWNER)
- **Authorized official phone:** (859) 219-2828

## Contact information

- **Practice address:** 135 EAST MAKWELL ST., SUITE 200, LEXINGTON, KY 40508
- **Practice address phone:** (859) 422-4363
- **Practice address fax:** (859) 422-4357
- **Mailing address:** P.O. BOX 23523, LEXINGTON, KY 40523-3523
- **Mailing address phone:** (859) 422-4363
- **Mailing address fax:** (859) 422-4357

## Taxonomy

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

## Other

- **Enumeration date:** 05/16/2006
- **Last updated:** 07/25/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000004074 | BCBS | — |
| 05 | — | 78905098 | — | KY |