Individual
RAE EAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2101 NICHOLASVILLE RD, STE 106, LEXINGTON, KY 40503-2517
(859) 278-5926
(859) 276-3189
Mailing address
3198 CUSTER DR, STE 100, LEXINGTON, KY 40517-4074
(859) 231-6996
(859) 255-4104
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3008431
KY
363LF0000X
Family Nurse Practitioner
3008431
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100272720
—
KY
Enumeration date
02/11/2014
Last updated
10/23/2019
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