Individual
AMY ANTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
160 N EAGLE CREEK DR, LEXINGTON, KY 40509-2121
(859) 263-0022
(859) 263-4666
Mailing address
160 N EAGLE CREEK DR, LEXINGTON, KY 40509-2121
(859) 263-0022
(859) 263-4666
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 118
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000374870
ANTHEM
KY
05
—
95000758
—
KY
Enumeration date
10/04/2006
Last updated
01/14/2022
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