Provider Demographics
NPI:1649319518
Name:GIERHART, LILLIAN E (ARNP)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:E
Last Name:GIERHART
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1724
Mailing Address - Street 2:
Mailing Address - City:CADIZ
Mailing Address - State:KY
Mailing Address - Zip Code:42211-1724
Mailing Address - Country:US
Mailing Address - Phone:270-522-3444
Mailing Address - Fax:270-522-3425
Practice Address - Street 1:250 MAIN ST
Practice Address - Street 2:
Practice Address - City:CADIZ
Practice Address - State:KY
Practice Address - Zip Code:42211-9153
Practice Address - Country:US
Practice Address - Phone:270-522-3444
Practice Address - Fax:270-522-3425
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005111363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78901527OtherMEDICAID GROUP
KY00000056637OtherANTHEM BLUE CROSS
KY7100007920Medicaid
KY7100007920Medicaid