Provider Demographics
NPI:1922653989
Name:KERN, EMILY NICOLE (APRN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:NICOLE
Last Name:KERN
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 1:9510 ORMSBY STATION RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4082
Mailing Address - Country:US
Mailing Address - Phone:502-327-9100
Mailing Address - Fax:
Practice Address - Street 1:740 S LIMESTONE J107
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-4082
Practice Address - Country:US
Practice Address - Phone:859-323-5603
Practice Address - Fax:859-323-3704
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3013736363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100619170Medicaid
CAQHOther14525080