Provider Demographics
NPI:1225617582
Name:NORTON, KAELA REBECCA
Entity Type:Individual
Prefix:
First Name:KAELA
Middle Name:REBECCA
Last Name:NORTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 CROSBY DR APT 1504
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-1863
Mailing Address - Country:US
Mailing Address - Phone:502-767-1309
Mailing Address - Fax:
Practice Address - Street 1:1401 HARRODSBURG RD STE C100
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-1780
Practice Address - Country:US
Practice Address - Phone:859-278-4960
Practice Address - Fax:859-278-0033
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical