Provider Demographics
NPI:1962940718
Name:YEARSLEY, LISA C (ANCC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:C
Last Name:YEARSLEY
Suffix:
Gender:F
Credentials:ANCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:989 GOVERNORS LN STE 180
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1174
Mailing Address - Country:US
Mailing Address - Phone:859-338-3958
Mailing Address - Fax:859-368-8135
Practice Address - Street 1:989 GOVERNORS LN STE 180
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1174
Practice Address - Country:US
Practice Address - Phone:859-338-3958
Practice Address - Fax:859-368-8135
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-01
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3011002363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology