Provider Demographics
NPI:1396831566
Name:COOMBS, LENNEA ELIZABETH (PA-C)
Entity Type:Individual
Prefix:MS
First Name:LENNEA
Middle Name:ELIZABETH
Last Name:COOMBS
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1930 BISHOP LN
Mailing Address - Street 2:SUITE 1017
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-1921
Mailing Address - Country:US
Mailing Address - Phone:502-272-5754
Mailing Address - Fax:502-272-5339
Practice Address - Street 1:315 E BROADWAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3700
Practice Address - Country:US
Practice Address - Phone:502-629-2500
Practice Address - Fax:502-629-2055
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2021-01-12
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Provider Licenses
StateLicense IDTaxonomies
KYPA744363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100286430Medicaid
KY7100286430Medicaid