Provider Demographics
NPI:1770759847
Name:KENTUCKY NEPHROLOGY SERVICES, LLC
Entity type:Organization
Organization Name:KENTUCKY NEPHROLOGY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIGRUN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:859-879-2113
Mailing Address - Street 1:PO BOX 910341
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40591-0341
Mailing Address - Country:US
Mailing Address - Phone:859-879-2113
Mailing Address - Fax:859-873-1367
Practice Address - Street 1:703 E MAIN ST
Practice Address - Street 2:SUITE #2
Practice Address - City:LEBANON
Practice Address - State:KY
Practice Address - Zip Code:40033-8695
Practice Address - Country:US
Practice Address - Phone:859-879-2113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment