Individual
MATTIE CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1740 NICHOLASVILLE RD, LEXINGTON, KY 40503-1431
(859) 260-6348
(859) 260-4350
Mailing address
1740 NICHOLASVILLE RD, LEXINGTON, KY 40503-1431
(859) 260-6348
(859) 260-4350
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TC110
KY
Other
Enumeration date
06/02/2025
Last updated
11/23/2025
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