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Individual

JUSTIN TYLER NEIDIG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
800 ROSE ST, LEXINGTON, KY 40536-1431
(859) 323-5956
(859) 323-1080
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
3012999
KY

Other

Enumeration date
01/07/2019
Last updated
07/18/2022
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