Provider Demographics
NPI:1316459142
Name:HARGETT, KAITLYN (PT, DPT)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:HARGETT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 PALMS DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3234
Mailing Address - Country:US
Mailing Address - Phone:859-640-4568
Mailing Address - Fax:
Practice Address - Street 1:2115 PALMS DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3234
Practice Address - Country:US
Practice Address - Phone:859-640-4568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-02
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008770225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYYRP903M63111OtherANTHEM BLUECROSS BLUESHIELD