Individual
AMY KATHRYN NYDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-4950
(859) 258-4618
Mailing address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-6200
(859) 258-6203
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3011568
KY
363LF0000X
Family Nurse Practitioner
3011568
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100493980
—
KY
Enumeration date
08/25/2017
Last updated
06/12/2026
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