Individual
STEPHEN GLENN RAFFERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
800 ROSE ST, LEXINGTON, KY 40536-7001
(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
3005062
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200897630A
—
IN
05
—
7100039070
—
KY
Enumeration date
09/21/2006
Last updated
01/15/2025
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