Provider Demographics
NPI:1811007180
Name:WILLIAMS, LOVORIA BRECKLEY (NP)
Entity type:Individual
Prefix:
First Name:LOVORIA
Middle Name:BRECKLEY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LOVORIA
Other - Middle Name:BRECKLEY
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, FNP-BC, TTS
Mailing Address - Street 1:751 ROSE ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-7000
Mailing Address - Country:US
Mailing Address - Phone:859-323-5579
Mailing Address - Fax:
Practice Address - Street 1:1350 BULL LEA RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511-1247
Practice Address - Country:US
Practice Address - Phone:859-246-7802
Practice Address - Fax:859-323-1057
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012759363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily