Provider Demographics
NPI:1821039215
Name:LAIN, KRISTINE YODER (MD)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:YODER
Last Name:LAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E LIBERTY ST
Mailing Address - Street 2:SUITE 800
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1434
Mailing Address - Country:US
Mailing Address - Phone:606-933-0780
Mailing Address - Fax:606-330-7825
Practice Address - Street 1:170 N EAGLE CREEK DR
Practice Address - Street 2:SUITE 110
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-9087
Practice Address - Country:US
Practice Address - Phone:859-263-0141
Practice Address - Fax:859-263-8669
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39833207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
50028316OtherNMFMS/PHP
000000657584OtherNMF/ANTHEM
000000657584OtherNMFMS/ANTHEM
000052153GOtherNMF/HUMANA
000052153GOtherNMFMS/HUMANA
3400434OtherNMFMS/CIGNA
KY64106032Medicaid
113348OtherNMF/SIHO
IN200843980Medicaid
KY0929190Medicare PIN
000000657584OtherNMF/ANTHEM
000052153GOtherNMFMS/HUMANA