Provider Demographics
NPI:1376742932
Name:LYKINS, WENDY E (APRN)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:E
Last Name:LYKINS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 S KY 7
Mailing Address - Street 2:
Mailing Address - City:SANDY HOOK
Mailing Address - State:KY
Mailing Address - Zip Code:41171-6830
Mailing Address - Country:US
Mailing Address - Phone:606-738-5155
Mailing Address - Fax:
Practice Address - Street 1:390 S KY 7
Practice Address - Street 2:
Practice Address - City:SANDY HOOK
Practice Address - State:KY
Practice Address - Zip Code:41171-6830
Practice Address - Country:US
Practice Address - Phone:606-738-5155
Practice Address - Fax:606-738-5420
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005235363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100015280Medicaid
KY3005235OtherKY MEDICAL LICENSE