Provider Demographics
NPI:1982672325
Name:WILSON, KAY G (APRN, DNP)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:G
Last Name:WILSON
Suffix:
Gender:F
Credentials:APRN, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2416 REGENCY RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2954
Mailing Address - Country:US
Mailing Address - Phone:859-278-1316
Mailing Address - Fax:859-278-1316
Practice Address - Street 1:3470 BLAZER PKWY STE 300
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1887
Practice Address - Country:US
Practice Address - Phone:859-278-1316
Practice Address - Fax:859-276-3847
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3002751363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000321070OtherBCBS HHC
1199206OtherCHA HHC
KY78006301Medicaid
000000321070OtherBCBS HHC
1199206OtherCHA HHC