Provider Demographics
NPI:1932372059
Name:GUERRANT, NANCY LEE (OD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:LEE
Last Name:GUERRANT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2558 LARKIN ROAD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503
Mailing Address - Country:US
Mailing Address - Phone:859-277-9532
Mailing Address - Fax:859-277-1362
Practice Address - Street 1:2558 LARKIN RD STE 130
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3205
Practice Address - Country:US
Practice Address - Phone:859-277-9532
Practice Address - Fax:859-277-1362
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1085DT152W00000X, 152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100054840Medicaid
00869002Medicare PIN