Individual
MADISON CHARLOTTE NITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
900 SOUTH LIMESTONE ST, LEXINGTON, KY 40503
(859) 323-1100
Mailing address
1501 BELLAMY PL, LOUISVILLE, KY 40208-3701
(513) 454-4021
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
KY
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
KY
Other
Enumeration date
05/20/2026
Last updated
05/29/2026
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