Organization
BLUEGRASS PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN S. GILES (OWNER)
(859) 219-2828
Entity
Organization
Contact information
Practice address
135 EAST MAKWELL ST., SUITE 200, LEXINGTON, KY 40508
(859) 422-4363
(859) 422-4357
Mailing address
P.O. BOX 23523, LEXINGTON, KY 40523-3523
(859) 422-4363
(859) 422-4357
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000004074
BCBS
—
05
—
78905098
—
KY
Enumeration date
05/16/2006
Last updated
07/25/2008
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