Individual
GENESIS SONG BANGHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1740 NICHOLASVILLE RD, LEXINGTON, KY 40503-1431
(859) 260-6100
Mailing address
1740 NICHOLASVILLE RD, LEXINGTON, KY 40503-1431
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
102393
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
1101538
TX
367500000X
Certified Registered Nurse Anesthetist
7801
NC
Other
Enumeration date
07/01/2014
Last updated
08/07/2025
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