Provider Demographics
NPI:1730490921
Name:SUTCLIFFE, ROBIN (APRN)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:SUTCLIFFE
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:UK DIVISION OF DIGESTIVE DISEASES 800 ROSE ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1780 NICHOLASVILLE RD STE 202
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1412
Practice Address - Country:US
Practice Address - Phone:859-260-5051
Practice Address - Fax:859-260-5052
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006478363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1088116OtherWELLCARE OF KY
KY7100138490Medicaid
KY000000948426OtherANTHEM
KYK162361Medicare PIN