Provider Demographics
NPI:1558659862
Name:BUI, KAYLEE T (APRN)
Entity Type:Individual
Prefix:
First Name:KAYLEE
Middle Name:T
Last Name:BUI
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:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:210 E GRAY ST STE 1105
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3907
Practice Address - Country:US
Practice Address - Phone:502-583-1697
Practice Address - Fax:502-583-2120
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007004363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000057121HOtherHUMANA - NNIKY
KY50034186OtherPASSPORT & PASSPORT ADVTG - NNIKY
IN201034040Medicaid
KY9500719OtherCIGNA - NNIKY
KYP01048867OtherRAILROAD MEDICARE - NNIKY
KY7100170940Medicaid
KY000000724827OtherANTHEM - NNIKY
KY7100170940Medicaid