Provider Demographics
NPI:1750824116
Name:DENISON, LORI G (APRN)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:G
Last Name:DENISON
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 1:2036 REGENCY RD STE 2
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2309
Mailing Address - Country:US
Mailing Address - Phone:859-286-9046
Mailing Address - Fax:859-276-3726
Practice Address - Street 1:2036 REGENCY RD STE 2
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2309
Practice Address - Country:US
Practice Address - Phone:859-286-9046
Practice Address - Fax:859-276-3726
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-02
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010876363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100622640Medicaid