Green, Diane Rae

Green, Diane Rae is an individual health care provider with primary practice located at 1351 Newtown Pike Bldg 1 , Lexington KY 40511-1277. She recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as her primary health care specialty. Green, Diane Rae can be contacted via phone (859) 253-1686.

Contact Information

Primary practice address
1351 Newtown Pike Bldg 1 Lexington KY 40511-1277
Phone: (859) 253-1686
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X

Profile Details

NPI number 1104333905
LBN Legal business name Green, Diane Rae
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2018
Last updated Jan 3rd, 2018 - about 7 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 1104333905 NPPES
Kentucky MEDICAID 1790731081

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