Provider Demographics
NPI:1215449590
Name:UNIVERSITY OF KENTUCKY
Entity type:Organization
Organization Name:UNIVERSITY OF KENTUCKY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOC DEAN FINANCE ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:RIDDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-323-5935
Mailing Address - Street 1:770 ROSE ST # D103
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0297
Mailing Address - Country:US
Mailing Address - Phone:859-323-5935
Mailing Address - Fax:859-257-5859
Practice Address - Street 1:UK COLLEGE OF DENTISTRY
Practice Address - Street 2:770 ROSE STREET, MN328
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536
Practice Address - Country:US
Practice Address - Phone:859-323-3368
Practice Address - Fax:859-257-5859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-26
Last Update Date:2021-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty