Individual
JOEY KYLE CREEKBAUM III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, FNP-BC
Contact information
Practice address
800 ROSE ST, LEXINGTON, KY 40536-1714
(859) 257-1000
(859) 218-7658
Mailing address
413 ELM STREET HTS, VERSAILLES, KY 40383-1172
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3017891
KY
Other
Enumeration date
07/07/2022
Last updated
03/04/2025
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