Individual
CARMELA FLETCHER-GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1306 VERSAILLES RD STE 120, LEXINGTON, KY 40504-1795
(859) 259-2635
Mailing address
1306 VERSAILLES RD STE 120, LEXINGTON, KY 40504-1795
(859) 259-2635
(592) 547-8748
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA304
KY
363AM0700X
Medical Physician Assistant
PA304
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11478958
CAQH
KY
05
—
95002937
—
KY
01
—
970021336
RAILROAD MEDICARE
KY
Enumeration date
11/07/2005
Last updated
06/22/2022
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