Organization
KENTUCKY CARDIOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY NOVAK (PRACTICE MANAGER)
(859) 226-0031
Entity
Organization
Contact information
Practice address
161 N EAGLE CREEK DR, STE 400, LEXINGTON, KY 40509-9038
(859) 226-0031
(859) 226-0041
Mailing address
161 N EAGLE CREEK DR, STE 400, LEXINGTON, KY 40509-9038
(859) 226-0031
(859) 226-0041
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65939985
—
KY
Enumeration date
09/26/2006
Last updated
09/11/2023
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