Individual
STACE DOLLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1740 NICHOLASVILLE RD, LEXINGTON, KY 40503-1431
(859) 260-6656
Mailing address
425 LEWIS HARGETT CIR, LEXINGTON, KY 40503-3590
(859) 268-1030
(859) 269-4120
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3004728
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74006180
—
KY
Enumeration date
11/07/2006
Last updated
12/04/2023
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