Provider Demographics
NPI:1326004946
Name:BRATCHER, DIANA MAE (APRN)
Entity type:Individual
Prefix:MS
First Name:DIANA
Middle Name:MAE
Last Name:BRATCHER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:
Other - Last Name:NICHOLS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40743-0936
Mailing Address - Country:US
Mailing Address - Phone:859-277-3737
Mailing Address - Fax:859-277-3765
Practice Address - Street 1:3470 BLAZER PKWY STE 200
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1887
Practice Address - Country:US
Practice Address - Phone:859-277-3737
Practice Address - Fax:859-277-3765
Is Sole Proprietor?:No
Enumeration Date:2006-04-22
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3002015363LF0000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78001005Medicaid
KY0054960Medicare ID - Type Unspecified
KY78001005Medicaid