Individual
FAY ELLYN RAWSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
150 N EAGLE CREEK DR, LEXINGTON, KY 40509-1805
(859) 967-5778
Mailing address
277 VALLEY BROOK DRIVE, LEXINGTON, KY 40511-8783
(859) 619-1431
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
2592P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11627658
CAQH
KY
Enumeration date
05/11/2007
Last updated
07/08/2007
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