Gordy, Carrie

Gordy, Carrie is an individual health care provider with primary practice located at 1135 Red Mile Place , Lexington KY 40504. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Gordy, Carrie can be contacted via phone (859) 288-4053.

Contact Information

Primary practice address
1135 Red Mile Place Lexington KY 40504
Fax: (859) 288-4084
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 2358-P Kentucky

Profile Details

NPI number 1003955477
LBN Legal business name Gordy, Carrie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2007
Last updated Aug 4th, 2009 - about 15 years 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 1003955477 NPPES
Kentucky MEDICAID 78002011

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