Organization
BEFREE CENTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI WAGNER MSN, APRN (MG MBR)
(859) 967-9486
Entity
Organization
Contact information
Practice address
2387 PROFESSIONAL HEIGHTS DR, SUITE 10, LEXINGTON, KY 40503-3004
(859) 967-9486
(859) 368-7780
Mailing address
2387 PROFESSIONAL HEIGHTS DR, SUITE 10, LEXINGTON, KY 40503
(859) 967-9486
(859) 368-7780
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
KY
363L00000X
Nurse Practitioner
3002772
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
KY
Enumeration date
05/06/2015
Last updated
06/17/2015
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