Provider Demographics
NPI:1205861481
Name:KERN, CAROLINE M (ARNP)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:M
Last Name:KERN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1720 NICHOLASVILLE RD
Mailing Address - Street 2:SUITE 506
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1404
Mailing Address - Country:US
Mailing Address - Phone:859-260-6326
Mailing Address - Fax:859-260-6375
Practice Address - Street 1:1720 NICHOLASVILLE RD
Practice Address - Street 2:SUITE 506
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1404
Practice Address - Country:US
Practice Address - Phone:859-260-6326
Practice Address - Fax:859-260-6375
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3003644363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100086760Medicaid
KY7100091630Medicaid
KY01030Medicare UPIN