Provider Demographics
NPI:1215373519
Name:LYKINS, KERI RENEE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:KERI
Middle Name:RENEE
Last Name:LYKINS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:KERI
Other - Middle Name:
Other - Last Name:LUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 628
Mailing Address - Street 2:
Mailing Address - City:NANCY
Mailing Address - State:KY
Mailing Address - Zip Code:42544-0628
Mailing Address - Country:US
Mailing Address - Phone:606-288-0013
Mailing Address - Fax:606-288-9600
Practice Address - Street 1:PO BOX 628
Practice Address - Street 2:
Practice Address - City:NANCY
Practice Address - State:KY
Practice Address - Zip Code:42544-0628
Practice Address - Country:US
Practice Address - Phone:062-880-0136
Practice Address - Fax:606-288-9600
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4023920363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7101007070Medicaid