Individual
SAMANTHA TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1401 HARRODSBURG RD STE A120, LEXINGTON, KY 40504-3779
(859) 258-6784
(859) 258-6796
Mailing address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-6200
(859) 258-6203
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA726
KY
363AM0700X
Medical Physician Assistant
Primary
PA726
KY
363AS0400X
Surgical Physician Assistant
PA726
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95004040
—
KY
Enumeration date
11/28/2005
Last updated
03/31/2025
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