Individual
CHLOE GRACE OLDENDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 N EAGLE CREEK DR, LEXINGTON, KY 40509-1805
(859) 258-5300
(859) 258-5357
Mailing address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-6200
(859) 258-6203
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3618
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7101031420
—
KY
Enumeration date
05/31/2024
Last updated
03/25/2025
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