Individual
BRIAN BENNETT ELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA, MSN
Contact information
Practice address
800 ROSE ST, LEXINGTON, KY 40536-0001
(859) 323-5956
Mailing address
2333 ALUMNI PARK PLZ, SUITE 200, LEXINGTON, KY 40517-4012
(859) 257-7910
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3466A
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74004383
—
KY
Enumeration date
10/06/2006
Last updated
12/05/2007
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