Individual
TREVEN BACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, PMHNP-BC
Contact information
Practice address
310 S LIMESTONE, LEXINGTON, KY 40508-3008
(859) 226-7063
(859) 226-7266
Mailing address
411 SUMMIT ST, RICHMOND, KY 40475-2151
(859) 785-9360
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4005975
KY
Other
Enumeration date
07/13/2023
Last updated
06/21/2025
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