Provider Demographics
NPI:1891874780
Name:VINSON, JOHN C IV (APRN)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:C
Last Name:VINSON
Suffix:IV
Gender:M
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:1030 MONARCH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1843
Mailing Address - Country:US
Mailing Address - Phone:859-296-3141
Mailing Address - Fax:859-296-3144
Practice Address - Street 1:1030 MONARCH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1843
Practice Address - Country:US
Practice Address - Phone:859-296-3141
Practice Address - Fax:859-296-3144
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2016-10-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY4981P364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health