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
Phone: (859) 288-4053
Fax: (859) 288-4084
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003955477 | NPPES |
| Kentucky | MEDICAID | 78002011 |
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