Provider Demographics
NPI:1164133971
Name:LAMB, KRISTENE GAYLE (APRN)
Entity Type:Individual
Prefix:
First Name:KRISTENE
Middle Name:GAYLE
Last Name:LAMB
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KRISTENE
Other - Middle Name:GAYLE
Other - Last Name:BAUGHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:208 SARA MARIE LN
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-6069
Mailing Address - Country:US
Mailing Address - Phone:859-420-2656
Mailing Address - Fax:
Practice Address - Street 1:310 S LIMESTONE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-3008
Practice Address - Country:US
Practice Address - Phone:859-226-7063
Practice Address - Fax:859-226-7266
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-13
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3018682363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health