Provider Demographics
NPI:1639185184
Name:SPALDING, ELIZABETH DARLENE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:DARLENE
Last Name:SPALDING
Suffix:
Gender:F
Credentials:ARNP
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 23823
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40523-3823
Mailing Address - Country:US
Mailing Address - Phone:859-278-8772
Mailing Address - Fax:859-422-4361
Practice Address - Street 1:125 E MAXWELL ST
Practice Address - Street 2:SUITE 300
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-2678
Practice Address - Country:US
Practice Address - Phone:859-278-8772
Practice Address - Fax:859-422-4361
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4946P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
1231129OtherCHA HHC
000000504826OtherBCBS LPC
000000491339OtherBCBS HHC
1231129OtherCHA HHC
KYQ72089Medicare UPIN