Provider Demographics
NPI:1407521248
Name:HARE, MIKAYLA (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:
Last Name:HARE
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:MIKAYLA
Other - Middle Name:
Other - Last Name:DODSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1701 NICHOLASVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1458
Mailing Address - Country:US
Mailing Address - Phone:931-698-3773
Mailing Address - Fax:
Practice Address - Street 1:1150 LEXINGTON RD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-8300
Practice Address - Country:US
Practice Address - Phone:859-562-8599
Practice Address - Fax:859-257-1214
Is Sole Proprietor?:No
Enumeration Date:2021-08-13
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3016181363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner