Acosta Quintana, Alexey

Acosta Quintana, Alexey is an sole proprietor health care provider with primary practice located at 1000 Neighborhood Pl , Fairdale KY 40118-9697. He recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Nursing Service Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Acosta Quintana, Alexey can be contacted via phone (502) 361-2381.

Contact Information

Primary practice address
1000 Neighborhood Pl Fairdale KY 40118-9697
Phone: (502) 361-2381
Fax: (502) 996-8309
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 1171048 Kentucky
Nursing Service Providers / Pediatrics 163WP0200X 1171048 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 4014131 Kentucky

Profile Details

NPI number 1639818867
LBN Legal business name Acosta Quintana, Alexey
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 4th, 2022
Last updated Jul 17th, 2024 - about 5 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639818867 NPPES
Kentucky MEDICAID 31-000052

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