Provider Demographics
NPI:1588056089
Name:SUTTON, NIKITA (APRN)
Entity type:Individual
Prefix:
First Name:NIKITA
Middle Name:
Last Name:SUTTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 HARRODSBURG RD STE A530
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-1717
Mailing Address - Country:US
Mailing Address - Phone:024-068-1335
Mailing Address - Fax:833-471-6018
Practice Address - Street 1:1401 HARRODSBURG RD STE A530
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-1717
Practice Address - Country:US
Practice Address - Phone:024-068-1335
Practice Address - Fax:833-471-6018
Is Sole Proprietor?:No
Enumeration Date:2015-02-21
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1120689163W00000X
KY3009208363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100384030Medicaid