Individual
MRS. CHERYL ELAINE VANDERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
740 S LIMESTONE, STE D201, LEXINGTON, KY 40536
(859) 323-0079
(859) 257-6868
Mailing address
1101 VETERANS DRIVE, LEXINGTON, KY 40502-2236
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1859
KY
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
PA1859
KY
363AS0400X
Surgical Physician Assistant
PA1859
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1084070
PHYSICIAN ASSISTANT CERTIFICATION
—
Enumeration date
08/02/2013
Last updated
01/14/2021
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