Provider Demographics
NPI:1679712087
Name:MATHENY, JULIANN PAIGE (FNP-C, CPNP-AC)
Entity Type:Individual
Prefix:MS
First Name:JULIANN
Middle Name:PAIGE
Last Name:MATHENY
Suffix:
Gender:F
Credentials:FNP-C, CPNP-AC
Other - Prefix:MRS
Other - First Name:JULIANN
Other - Middle Name:PAIGE
Other - Last Name:STURM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, APRN
Mailing Address - Street 1:138 LEADER AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40506-9983
Mailing Address - Country:US
Mailing Address - Phone:502-693-0551
Mailing Address - Fax:
Practice Address - Street 1:138 LEADER AVE SUITE 119
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40506-3446
Practice Address - Country:US
Practice Address - Phone:859-323-7305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-09
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3011424363LF0000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily