Provider Demographics
NPI:1033512124
Name:PENN, LINDSAY ATHERTON (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:ATHERTON
Last Name:PENN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:ATHERTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:800 ROSE ST
Mailing Address - Street 2:UK - DIVISION OF HOSPITAL MEDICINE
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0298
Mailing Address - Country:US
Mailing Address - Phone:859-323-6047
Mailing Address - Fax:859-257-3873
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:UK - DIVISION OF HOSPITAL MEDICINE
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0298
Practice Address - Country:US
Practice Address - Phone:859-323-6047
Practice Address - Fax:859-257-3873
Is Sole Proprietor?:No
Enumeration Date:2014-10-02
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA1911363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant