Individual
SERGE NDETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1306 VERSAILLES RD STE 120, LEXINGTON, KY 40504-1795
(859) 259-2635
(859) 254-7874
Mailing address
1306 VERSAILLES RD STE 120, LEXINGTON, KY 40504-1795
(859) 259-2635
(859) 254-7874
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3017475
KY
Other
Enumeration date
02/13/2023
Last updated
12/04/2025
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