Provider Demographics
NPI:1639624067
Name:NOBLE, AMY JO (APRN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JO
Last Name:NOBLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:JO
Other - Last Name:BLEVINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:UK DIVISION OF HEMATOLOGY BMT
Mailing Address - Street 2:800 ROSE STREET
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0001
Mailing Address - Country:US
Mailing Address - Phone:859-323-5768
Mailing Address - Fax:859-257-7715
Practice Address - Street 1:200 NEW YORK AVE STE 200
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-5225
Practice Address - Country:US
Practice Address - Phone:865-835-5400
Practice Address - Fax:865-835-5401
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-15
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010416363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ046281Medicaid